Holly, Taina S.

Holly, Taina S. is an individual health care provider with primary practice located at 1234 Elgin Way , Riverdale GA 30296. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Holly, Taina S. can be contacted via phone (770) 629-1565.

Contact Information

Primary practice address
1234 Elgin Way Riverdale GA 30296
Phone: (770) 629-1565
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X LPN061999 Georgia

Profile Details

NPI number 1104069517
LBN Legal business name Holly, Taina S.
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2009
Last updated Apr 15th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1104069517 NPPES
Georgia Other 031012479 GA OFFICE OF REG. SERVICE

Popular Providers