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NPI Code Detail

MEDICARE: MRS. CAROLINE REAGAN HOLLAND MASTER OF SCIENCE

MEDICARE:  MRS. CAROLINE REAGAN HOLLAND  MASTER OF SCIENCE
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
1247200000XOther Technician

General Provider Information

NPI Number : 1396869426
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLINE REAGAN HOLLAND MASTER OF SCIENCE
Provider Business Mailing Address
First Line : PO BOX 9054
Second Line :
City : GRAY
State : TN
Zip : 37615-9054
Country : US
Telephone Number : 423-467-3600
Fax Number : 423-467-3644
Provider Business Practice Location Address
First Line : 2243 EDDIE WILLIAMS RD
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601
Country : US
Telephone Number : 423-928-5627
Fax Number : 423-928-4222
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. CAROLINE REAGAN HOLLAND MASTER OF SCIENCE” Practice Location

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