Individual provider Active NPI

Stephanie D Holliday, APRN, FNP-BC

  • Family Nurse Practitioner
  • Lewisburg, WV
National Provider Identifier
1750994240
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
107261 Issued in WV
Practice address
1126 Maplewood Ave
Lewisburg, WV 24901-5932
Phone
(304) 667-4166
NPI assigned
Aug 25, 2020
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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 107261 WV Primary

Addresses

Primary practice location

1126 Maplewood Ave
Lewisburg, WV 24901-5932

Mailing address

1126 Maplewood Ave
Lewisburg, WV 24901-5932
Phone (304) 667-4166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210610001981 WV Practitioner - Nurse Practitioner 9739589805 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. Current Accepting new patients
Charleston Area Medical Center Inc CurrentSince Feb 26, 2021 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Feb 26, 2021 Accepting new patients
Greenbrier Care LLC PastSince May 1, 2023 Accepting new patients

Locations

1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1750994240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 MAPLEWOOD AVE",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249015932",
            "telephone_number": "304-667-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 MAPLEWOOD AVE",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249015932",
            "telephone_number": "304-667-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "STEPHANIE",
        "middle_name": "D",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "107261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, WV

Sources for this page

Verify at the official NPI Registry.