Provider Demographics
NPI:1174388524
Name:HOLLINGSWORTH, THLISHA BONVILLE
Entity type:Individual
Prefix:MS
First Name:THLISHA
Middle Name:BONVILLE
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:THLISHA
Other - Middle Name:ANN
Other - Last Name:BONVILLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3201 EDRICH WAY
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-3540
Mailing Address - Country:US
Mailing Address - Phone:302-331-0840
Mailing Address - Fax:
Practice Address - Street 1:457 SWEEPING MIST CIR
Practice Address - Street 2:
Practice Address - City:FREDERICA
Practice Address - State:DE
Practice Address - Zip Code:19946-2406
Practice Address - Country:US
Practice Address - Phone:302-331-0840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula