Individual
LISSA S HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
532 1ST ST NW, BRITT, IA 50423-1227
(641) 843-5050
(641) 843-5051
Mailing address
532 1ST ST NW, BRITT, IA 50423-1227
(641) 843-5050
(641) 843-5051
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000789
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42915
WELLMARK BRITT CLINIC
IA
01
—
42917
WELLMARK - KANAWHA CLINIC
IA
Enumeration date
07/12/2006
Last updated
07/08/2007
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