Provider Demographics
NPI:1174728083
Name:HOLDEMAN, DEBORAH ANN (FNP)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANN
Last Name:HOLDEMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5517 LAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1508
Mailing Address - Country:US
Mailing Address - Phone:510-652-6697
Mailing Address - Fax:
Practice Address - Street 1:3232 ELM ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3050
Practice Address - Country:US
Practice Address - Phone:510-869-8761
Practice Address - Fax:510-869-6903
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA441923NP4995363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health