Individual
CAMILLA EARLENE HOLLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, PA-C
Contact information
Practice address
1057 MARTINSBURG PIKE, WINCHESTER, VA 22603-5409
(540) 665-3299
Mailing address
1775 N SECTOR CT, WINCHESTER, VA 22601-2859
(540) 542-6208
(540) 542-6210
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110002830
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871742825
—
VA
01
—
P00765854
RAILROAD MEDICARE
—
Enumeration date
09/15/2008
Last updated
07/26/2016
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