| NPI | 1215632252 |
|---|---|
| Former Name | HOLLY JEANINE PEDERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11042751) |
| Enumeration Date | 2023-03-31 |
| Last Update Date | 2025-10-16 |