Individual
SHANNON K HOLLOMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
600 GRESHAM DR STE 204, NORFOLK, VA 23507-1904
(757) 388-5680
Mailing address
600 GRESHAM DR STE 204, NORFOLK, VA 23507-1904
(757) 388-5680
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004593
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10160253P
OPTIMA HEALTH
VA
01
—
1528472818
HUMANA
VA
05
—
1528472818
—
VA
01
—
565258
BLUE CROSS BLUE SHIELD SUPPLEMENT
VA
Enumeration date
06/16/2014
Last updated
08/26/2022
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