Individual
MARIA JANE HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2205 RIVERSTONE BLVD STE 205, CANTON, GA 30114-5250
(770) 720-5011
(770) 345-1088
Mailing address
2205 RIVERSTONE BLVD STE 205, CANTON, GA 30114-5250
(770) 720-5011
(770) 345-1088
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2001708004NP-PP
OR
363LF0000X
Family Nurse Practitioner
RN223280
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN223280
GA
Other
Enumeration date
06/14/2016
Last updated
12/27/2023
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