Holloway, Lucy S

Holloway, Lucy S is an individual health care provider with primary practice located at 509 Brookman Dr , Brookhaven MS 39601-2326. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Holloway, Lucy S can be contacted via phone (601) 823-5204.

Contact Information

Primary practice address
509 Brookman Dr Brookhaven MS 39601-2326
Fax: (601) 833-1224
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R873648 Mississippi

Profile Details

NPI number 1629349931
LBN Legal business name Holloway, Lucy S
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2012
Last updated Oct 25th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629349931 NPPES
Mississippi MEDICAID 06571037

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