| Name: | Janet Holley CRNP, PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 13 Jul 2010 (14 years ago) |
| Date of dissolution: | 29 Dec 2011 |
| Entity Number: | 000-264-712 |
| Register Number: | 000264712 |
| County: | Winston |
| Place of Formation: | Winston County |
| Principal Address: | HALEYVILLE, AL |
| Registered Office Street Address: | 400 CO RD 3418HALEYVILLE, AL 35565 |
| Registered Office Street Address ZIP Code: | 35565 |
| Authorized Capital: | $2,000 |
Activities
CERTIFIED REGISTERED NURSE PRACTITIONER
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598079600 | 2010-07-30 | 2010-12-06 | 42030 HIGHWAY 195 STE D, P O BOX 970, HALEYVILLE, AL, 355657054, US | 42030 HIGHWAY 195, SUITE D, HALEYVILLE, AL, 355657054, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 205-486-2743 |
| Fax | 2054864343 |
Authorized person
| Name | JANET L HOLLEY |
| Role | MANAGER |
| Phone | 2054862743 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | 1-069794 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RR MEDICARE |
| Number | P00431210 |
| State | AL |
| Issuer | MEDICAID |
| Number | 891017150 |
| State | AL |
| Name | Role |
|---|---|
| HOLLEY, JANET | Agent |
| Name | Role |
|---|---|
| HOLLEY, JANET | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
