Provider Demographics
NPI:1891674768
Name:HOLDEN, MAKAYLA DYANNE (ACNPC-AG)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:DYANNE
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 PALFREY DR
Mailing Address - Street 2:
Mailing Address - City:RIDGEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29472-6468
Mailing Address - Country:US
Mailing Address - Phone:574-238-8091
Mailing Address - Fax:
Practice Address - Street 1:8 RICHLAND MEDICAL PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-8006
Practice Address - Country:US
Practice Address - Phone:803-434-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC253454363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care