Active NPI
Kimberly Holloway
- Lactation Consultant (Registered Nurse)
- St Johns, FL
National Provider Identifier
1770434508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Registered Nurse)
- License
- L-103567
- Practice address
- 120 Weathered Oak CT
St Johns, FL 32259-7265 - Phone
- (904) 347-8530
- NPI assigned
- Feb 6, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Registered Nurse) | 163WL0100X | L-103567 | FL | Primary |
Addresses
Primary practice location
120 Weathered Oak CT
St Johns, FL 32259-7265
Mailing address
120 Weathered Oak CT
St Johns, FL 32259-7265
Phone (904) 347-8530
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L-103567 | FL | MD | Lactation Consultant (Registered Nurse) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1770336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770336000000",
"number": "1770434508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 WEATHERED OAK CT",
"city": "ST JOHNS",
"state": "FL",
"postal_code": "322597265",
"telephone_number": "904-347-8530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 WEATHERED OAK CT",
"city": "ST JOHNS",
"state": "FL",
"postal_code": "322597265",
"telephone_number": "904-347-8530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-02-06",
"last_updated": "2026-02-06",
"certification_date": "2026-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "163WL0100X",
"taxonomy_group": "",
"desc": "Registered Nurse, Lactation Consultant",
"state": "FL",
"license": "L-103567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Johns, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.