Deanne Lee Holliday, RN

Key facts

NPI

1508522509

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

315339 (NC)

Practice address

5537 Wyse Fork Rd
Dover, NC 28526-8839

Phone

(252) 523-1065

NPI assigned

Nov 13, 2021

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 13, 2021.

{
    "created_epoch": "1636761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636761600000",
    "number": "1508522509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5537 WYSE FORK RD",
            "city": "DOVER",
            "state": "NC",
            "postal_code": "285268839",
            "telephone_number": "252-523-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5537 WYSE FORK RD",
            "city": "DOVER",
            "state": "NC",
            "postal_code": "285268839",
            "telephone_number": "252-523-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "DEANNE",
        "middle_name": "LEE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-13",
        "last_updated": "2021-11-13",
        "certification_date": "2021-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "315339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NC

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All providers in Dover, NC · Registered Nurse in North Carolina