Individual
SHANA M HOLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1018
NV
363AM0700X
Medical Physician Assistant
PA662
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116033
—
AL
01
—
1881745081
MEDICAID - SMA
NV
01
—
650622859
TAX ID
AL
01
—
PA1018
NEVADA PA LICENSE
NV
01
—
PA662
STATE LICENSE
AL
01
—
V108405
SMACC MEDICARE
NV
Enumeration date
01/15/2007
Last updated
10/23/2025
Update your record
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