| NPI | 1215531264 |
|---|---|
| Former Name | MARISSA PAIGE HOLLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209021387) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020014749) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2024-05-20 |