Individual provider Active NPI

Marni Gwyther Holder, RN, FNP

  • Family Nurse Practitioner
  • Carrboro, NC
National Provider Identifier
1508987926
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
151219 Issued in NC
Practice address
299 Lloyd St
Carrboro, NC 27510-1821
Phone
(919) 933-8494
Fax
(919) 933-9201
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 151219 NC Primary

Addresses

Primary practice location

299 Lloyd St
Carrboro, NC 27510-1821

Mailing address

1802 Hideaway LN
Durham, NC 27712-2636
Phone (919) 697-0311

Other identifiers 1

IdentifierTypeStateIssuer
200912OtherNCNC MEDICAL BOARD NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
151219NCMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508987926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 HIDEAWAY LN",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277122636",
            "telephone_number": "919-697-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 LLOYD ST",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275101821",
            "telephone_number": "919-933-8494",
            "fax_number": "919-933-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "MARNI",
        "middle_name": "GWYTHER",
        "name_prefix": "Ms.",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "151219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAL BOARD NUMBER",
            "identifier": "200912",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.