Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 200100420 | NC |
NPI | 1043200207 |
---|---|
Provider Name | Holly Murrell Mcpherson |
First Address | Skyland, NC 28776-2207 |
Second Address | Winston Salem, NC 27103-2932 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 17/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2288954 | MEDICARE PTAN (01) | NC |
89129PA | (05) | NC |
H40236 | (02) |