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

Penny Marie Holley, FNP

Individual provider Family Nurse Practitioner · NPI 1013524495

Penny Marie Holley, FNP is a Nurse Practitioner in Southaven, Mississippi. Qualified in 2020, 6 years ago. Practices with Convenient Care Clinic LLC, a 19-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
6
Licensed in
MS
In the registry since
2020
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

3964 Goodman Rd E Ste 128-129
Southaven, MS 38672-8761
Phone: (662) 655-0456
Fax: (662) 655-0457
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 868493 (MS)

Record details

NPI number1013524495
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedSeptember 29, 2020
Last updated in NPPESMarch 1, 2023
Certification dateMarch 1, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Convenient Care Clinic Llc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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