Individual
AMBER HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4934
(662) 377-3270
Mailing address
830 S GLOSTER ST, TUPELO, MS 38801-4996
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904692
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/17/2020
Last updated
04/07/2022
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