Individual
CARRIE JANE HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18600 WEDGE PARKWAY, NEIL J. REDFIELD BLDG. A, SUITE 104, RENO, NV 89511
(775) 784-4843
Mailing address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(575) 622-8170
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2021-0094
NM
363A00000X
Physician Assistant
PA64940
CA
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
07/20/2020
Last updated
09/26/2024
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