Individual
DORIS GLENDA HOLLIDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MAGNOLIA ST, MAGNOLIA, MS 39652-2825
(601) 783-2374
Mailing address
1177 IRMA DR, MAGNOLIA, MS 39652-9123
(601) 730-1164
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
905158
MS
Other
Enumeration date
02/10/2022
Last updated
02/19/2022
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