Provider Demographics
NPI:1730728528
Name:LANDIN, HOLLI MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:HOLLI
Middle Name:MARIE
Last Name:LANDIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:MARIE
Other - Last Name:BEARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2509 SCRIPTURE ST STE 220
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2324
Mailing Address - Country:US
Mailing Address - Phone:940-891-0808
Mailing Address - Fax:940-891-0809
Practice Address - Street 1:2509 SCRIPTURE ST STE 220
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2324
Practice Address - Country:US
Practice Address - Phone:940-891-0808
Practice Address - Fax:940-891-0809
Is Sole Proprietor?:No
Enumeration Date:2019-12-27
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13365363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical