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NPI Code Detail

MEDICARE: PAMELA HOLLIS

MEDICARE: PAMELA HOLLIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker7420-CNV
21041C0700XClinical Social WorkerC008008NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346432374
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA HOLLIS
Provider Business Mailing Address
First Line : 8512 ARCO IRIS LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-7951
Country : US
Telephone Number : 704-692-9596
Fax Number :
Provider Business Practice Location Address
First Line : 5412 BOULDER HWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89122-6039
Country : US
Telephone Number : 702-291-2171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2007
Last Update Date : 02/28/2017

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Directions to “ PAMELA HOLLIS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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