Provider Demographics
NPI:1538799408
Name:O'TOOLE, HOLLY (RN-BC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:O'TOOLE
Suffix:
Gender:F
Credentials:RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 BORDERLINE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-3584
Mailing Address - Country:US
Mailing Address - Phone:850-294-7424
Mailing Address - Fax:
Practice Address - Street 1:2606 CENTENNIAL PL
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-0572
Practice Address - Country:US
Practice Address - Phone:850-205-0189
Practice Address - Fax:850-329-2903
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9408188163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult