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General NPI Number Information
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NPI Number | 1649083304
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Entity Type | Individual
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Provider Name | AMANDA LYNN HOLLIS RN
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Gender | Female
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 3000 NEW BERN AVE
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City | RALEIGH
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State | NC
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Zip | 27610-1231
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Country | US
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Telephone | 919-350-2883
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Fax |
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Provider Business Mailing Address
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Address Line | 8225 US 264 ALTERNATE
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City | BAILEY
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State | NC
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Zip | 27807
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Country | US
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Telephone | 252-235-8481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 333568
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License Number State | NC
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