Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

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
Show map & directions

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

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Northside Surgical Professional Services LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 368 clinicians in the practice; 12 are shown here.

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