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Individual

MRS. KELLY HOLDERFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
5261 CARROLLTON PIKE, SUITE C, WOODLAWN, VA 24381-3034
(276) 238-0911
(276) 238-0912
Mailing address
5261 CARROLLTON PIKE, SUITE C, WOODLAWN, VA 24381-3034
(276) 238-0911
(276) 238-0912

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024173248
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0017142656
AUTHORIZATION TO PRESCRIBE
VA
01
0024173248
FNP LICENSE
VA
Enumeration date
02/02/2016
Last updated
07/14/2021
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