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Individual

PAMELA DENESE HOLLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
11 BYRON NELSON, SAN ANTONIO, TX 78257-1726
(602) 793-3380
Mailing address
11 BYRON NELSON, SAN ANTONIO, TX 78257-1726
(602) 793-3380

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
240922
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP103210
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0480280
BLUE CROSS BLUE SHIELD
AZ
01
750332
AHCCS #
AZ
01
AZ144000&AZ480280
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
06/29/2006
Last updated
10/18/2016
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