Healthcare Provider Details

I. General information

NPI: 1235703323
Provider Name (Legal Business Name): TAMEKA ELAINE HOLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 KINGSLAND AVE STE 100
SAINT LOUIS MO
63130-3187
US

IV. Provider business mailing address

725 KINGSLAND AVE STE 100
SAINT LOUIS MO
63130-3187
US

V. Phone/Fax

Practice location:
  • Phone: 314-720-3355
  • Fax: 314-254-8355
Mailing address:
  • Phone: 314-720-3355
  • Fax: 314-254-8355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: