Healthcare Provider Details

I. General information

NPI: 1619381209
Provider Name (Legal Business Name): KATHLEEN JOAN HOLLAND M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN JOAN CORNFIELD M.D., M.P.H.

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 06/22/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PRINGLE WAY STE 505
RENO NV
89502-1469
US

IV. Provider business mailing address

1155 MILL ST # MS 14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-329-4600
  • Fax: 775-329-4992
Mailing address:
  • Phone: 775-982-5262
  • Fax: 775-982-3900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number20499
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number20499
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: