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Individual

EDRIS Y HOLLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN MSN FNP-C

Contact information

Practice address
520 W PALMDALE BLVD, PALMDALE, CA 93551-4229
(661) 947-3300
(661) 947-3322
Mailing address
41405 SEQUOIA AVE, PALMDALE, CA 93551-1912
(310) 672-4581

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
374283
CA
163WC1500X
Community Health Registered Nurse
374283
CA
363LF0000X
Family Nurse Practitioner
Primary
95017058
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95017058
FNP-C LICENSE NUMBER
CA
Enumeration date
10/09/2020
Last updated
04/11/2021
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