Individual
MRS. CAROL EDWARDS HOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
400 MILITARY HEIGHTS PL, ROSWELL, NM 88201-6407
(575) 627-9500
(575) 627-9535
Mailing address
1112 N MAIN ST, ROSWELL, NM 88201-5010
(575) 627-4200
(575) 627-4212
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
CNP00402
NM
363LF0000X
Family Nurse Practitioner
Primary
R23239
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932187044
GROUP NPI
NM
05
—
65000579
—
NM
01
—
74-2823514
GROUP TAX ID
NM
01
—
800521089
GROUP MEDICARE
NM
Enumeration date
02/24/2006
Last updated
02/03/2022
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