Individual
KATHERINE RAE HOLYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN AGPCNP-C
Contact information
Practice address
5758 COOLEY LAKE RD, WATERFORD, MI 48327-3073
(855) 466-3631
(810) 244-0226
Mailing address
5758 COOLEY LAKE RD, WATERFORD, MI 48327-3073
(855) 466-3631
(810) 244-0226
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
4704282989
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
4704282989
MI
363LP2300X
Primary Care Nurse Practitioner
4704282989
MI
Other
Enumeration date
05/11/2017
Last updated
05/31/2024
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