Healthcare Provider Details

I. General information

NPI: 1306028618
Provider Name (Legal Business Name): PAMELA MAHAR HOLT RN-BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BRENNER AVE
SALISBURY NC
28144-2515
US

IV. Provider business mailing address

304 KNOLLWOOD AVE
SALISBURY NC
28144-7595
US

V. Phone/Fax

Practice location:
  • Phone: 704-638-9000
  • Fax: 704-645-6099
Mailing address:
  • Phone: 704-637-1613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number062180
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: