Provider Demographics
NPI:1003506445
Name:HOLEVAS, LEA MARIA (PA-C)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:MARIA
Last Name:HOLEVAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-9740
Mailing Address - Fax:704-384-9565
Practice Address - Street 1:1500 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4656
Practice Address - Country:US
Practice Address - Phone:704-384-9740
Practice Address - Fax:704-384-9565
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2024-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-14130363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant