Provider Demographics
NPI:1891670675
Name:HOLIFIELD, MEMECO (RN)
Entity type:Individual
Prefix:
First Name:MEMECO
Middle Name:
Last Name:HOLIFIELD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 WILD TIMBER PKWY
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2530
Mailing Address - Country:US
Mailing Address - Phone:205-413-9704
Mailing Address - Fax:
Practice Address - Street 1:181 WILD TIMBER PKWY
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2530
Practice Address - Country:US
Practice Address - Phone:205-413-9704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-09
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-138692163W00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No163W00000XNursing Service ProvidersRegistered Nurse