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NPI Code Detail

MEDICARE: MRS. ELIZABETH MARIA HOLLIS NP

MEDICARE: MRS. ELIZABETH MARIA HOLLIS NP
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
1363LF0000XFamily Nurse PractitionerR138048 NPGA

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 : 1609889021
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH MARIA HOLLIS NP
Provider Business Mailing Address
First Line : 1500 E SHOTWELL ST
Second Line :
City : BAINBRIDGE
State : GA
Zip : 39819-4256
Country : US
Telephone Number : 229-246-3500
Fax Number :
Provider Business Practice Location Address
First Line : 1500 E SHOTWELL ST
Second Line :
City : BAINBRIDGE
State : GA
Zip : 39819-4256
Country : US
Telephone Number : 229-246-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 02/17/2012

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