| NPI | 1396855813 |
|---|---|
| Former Name | JUANITA DENAE HOLLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA15256) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 012000864) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 306479) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA60497) | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-04-03 |