Provider Demographics
NPI:1548360266
Name:HOLDSWORTH, JOAN ANN (RN ANPC)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:ANN
Last Name:HOLDSWORTH
Suffix:
Gender:F
Credentials:RN ANPC
Other - Prefix:MISS
Other - First Name:JOAN
Other - Middle Name:ANN
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3365 BUNKER AVENUE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793
Mailing Address - Country:US
Mailing Address - Phone:516-221-0942
Mailing Address - Fax:631-266-6040
Practice Address - Street 1:78 MIDDLEVILLE ROAD
Practice Address - Street 2:118
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:631-266-6040
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222506163W00000X
NY302107363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health