Basic Information
Provider Information
NPI: 1275045775
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLLAND
FirstName: BRIANNA
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 858
Address2: MC A410
City: HERSHEY
State: PA
PostalCode: 170330858
CountryCode: US
TelephoneNumber: 8002431455
FaxNumber:  
Practice Location
Address1: 500 UNIVERSITY DR
Address2:  
City: HERSHEY
State: PA
PostalCode: 170332360
CountryCode: US
TelephoneNumber: 7175318407
FaxNumber: 7175314077
Other Information
ProviderEnumerationDate: 10/25/2017
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XSP018292PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
163W00000XRN634826PAN Nursing Service ProvidersRegistered Nurse 

No ID Information.


Home