Healthcare Provider Details

I. General information

NPI: 1437968757
Provider Name (Legal Business Name): ROSALIND HOLLIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9202 HIGHWAY 278 NE STE 100E
COVINGTON GA
30014-7011
US

IV. Provider business mailing address

110 ABELIA DR
COVINGTON GA
30014-7472
US

V. Phone/Fax

Practice location:
  • Phone: 678-342-8677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN314617
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: