Individual
LINDA S HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, ARNP
Contact information
Practice address
1845 FAIRMOUNT STREET, 209 AHLBERG HALL ROOM 209, WICHITA, KS 67620-0092
(316) 978-3620
(316) 978-3517
Mailing address
1845 FAIRMOUNT STREET, 209 AHLBERG HALL ROOM 209, WICHITA, KS 67620-0092
(316) 978-3620
(316) 978-3517
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-44012-081
KS
363LW0102X
Women's Health Nurse Practitioner
44012
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10368460A
—
KS
01
—
110035
BCBS OF KS GROUP PROVIDER
KS
01
—
161387
BCBS OF KS INDIVIDUAL ID#
KS
Enumeration date
03/14/2007
Last updated
12/28/2015
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