Davontre Holland, is a
Nurse Practitioner - Primary Care based in Maplewood, Missouri. Davontre Holland is licensed to practice in Missouri (license number 2017007229) and his current practice location is
31 Sunnen Dr Apt 145, Maplewood, Missouri. He can be reached at his office (for appointments etc.) via phone at
(314) 799-4571.
NPI number for Davontre Holland is 1568318772 and his current mailing address is 31 Sunnen Dr Apt 145, Maplewood, Missouri. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1568318772.
Provider's Profile
| Full Name | Davontre Holland |
|---|
| Gender | Male |
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| Speciality | Nurse Practitioner - Primary Care |
|---|
| Location | 31 Sunnen Dr Apt 145, Maplewood, Missouri |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1568318772
- Provider Enumeration Date: 03/09/2026
- Last Update Date: 03/09/2026
Medical Identifiers
Medical identifiers for Davontre Holland such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568318772 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LP2300X | Nurse Practitioner - Primary Care | 2017007229 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Davontre Holland is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Davontre Holland,
31 Sunnen Dr Apt 145,
Maplewood, MO 63143-3830
Ph: (314) 799-4571 | Davontre Holland,
31 Sunnen Dr Apt 145,
Maplewood, MO 63143-3830
Ph: (314) 799-4571 |
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