Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 39616 | KY |
Y | 111NI0900X | Internist | 39616 | KY |
N | 207RA0401X | Internist - Addiction Medicine | 39616 | KY |
NPI | 1700896578 |
---|---|
Provider Name | Miss Pamela Holland |
First Address | Lexington, KY 40515-1716 |
Second Address | Lexington, KY 40515-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 03/07/2015 |