Provider Demographics
NPI:1942063003
Name:HOLLAND, ARIANNA MARIE (APRN-PMHNP)
Entity type:Individual
Prefix:
First Name:ARIANNA
Middle Name:MARIE
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:APRN-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12110 W JAYSON LN
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67235-1453
Mailing Address - Country:US
Mailing Address - Phone:316-640-6778
Mailing Address - Fax:
Practice Address - Street 1:1507 W 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-2449
Practice Address - Country:US
Practice Address - Phone:316-221-7310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82848-062363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health