Healthcare Provider Details
I. General information
NPI: 1144133992
Provider Name (Legal Business Name): HANNA ROSE HOLLAND PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1721 MEDICAL PARK DR STE 200
BILOXI MS
39532-2105
US
IV. Provider business mailing address
1721 MEDICAL PARK DR STE 200
BILOXI MS
39532-2105
US
V. Phone/Fax
- Phone: 228-392-7429
- Fax:
- Phone: 228-392-7429
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: