Provider Demographics
NPI:1871591339
Name:HOLLINGSWORTH, DEBORAH FAYE (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:FAYE
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1015
Mailing Address - Street 2:
Mailing Address - City:EMMETT
Mailing Address - State:ID
Mailing Address - Zip Code:83617-1015
Mailing Address - Country:US
Mailing Address - Phone:208-365-0890
Mailing Address - Fax:208-365-0950
Practice Address - Street 1:3777 VAN DUSSEN RD
Practice Address - Street 2:
Practice Address - City:EMMETT
Practice Address - State:ID
Practice Address - Zip Code:83617-9549
Practice Address - Country:US
Practice Address - Phone:208-365-0890
Practice Address - Fax:208-365-0950
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDN-33941, NP-701A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily