Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Stacie Dianne Holloway, FNP-BC

Individual provider Nurse Practitioner · NPI 1598048894

Mrs. Stacie Dianne Holloway, FNP-BC is a Nurse Practitioner in Atlanta, Georgia. Qualified in 2011, 15 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group and accepts Medicare assignment. Licensed in Georgia and Mississippi.

Years since qualifying
15
Licensed in
GA, MS
In the registry since
2011
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

1100 Johnson Fy Rd NE
Atlanta, GA 30342-1709
Phone: (404) 851-6284
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN333566 (GA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence R871001 (MS)

Record details

NPI number1598048894
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedSeptember 22, 2011
Last updated in NPPESMarch 4, 2025
Certification dateMarch 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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