ELIZABETH KOONTZ HOLLAND


Address: Medical Center Blvd, Winston Salem, NC 27157-0001
Phone: 3367162255

ELIZABETH KOONTZ HOLLAND (NPI# 1750366886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750366886
Entity Type Individual
Full Name ELIZABETH KOONTZ HOLLAND
Other Name MARY KOONTZ
Credential PAC
Practice Address Medical Center Blvd
Winston Salem
NC 27157-0001
Mailing Address Po Box 602658
Charlotte
NC 28260-2658
Practice Telephone 3367162255
Practice Fax Number 3367135424
Mailing Telephone 3367162255
Mailing Fax Number 3367135424
Enumeration Date 2005-12-13
Last Update Date 2012-06-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
000101509 NC Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NC MEDCOST 94676 01
AETNA 7338641 01

Other Providers ELIZABETH HOLLAND

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1528592383 Elizabeth Holland Psychologist 7440 W Marginal Way S, Seattle, WA 98108-4141 2017-04-18
1508310103 Elizabeth Anne Holland Psychologist 606 Commercial Ave, Suite E, Anacortes, WA 98221-1700 2016-08-11
1013237106 Elizabeth Pudish Holland Speech-Language Pathologist 1710 Nys Rte 13, Cortland, NY 13045-9617 2010-06-11
1568656072 Elizabeth B Holland Dentist 1920 Slaughter Rd, Madison, AL 35758-8619 2007-08-29
1659454213 Elizabeth Holland Recreation Therapist 95 Route 201, Fairfield, ME 04937-3303 2006-10-24
1467535385 Elizabeth Holland Registered Nurse 607 Hammond Plz, Hopkinsville, KY 42240-4971 2006-10-23
1538144977 Elizabeth A Holland Radiology 4440 W 95th St, Oak Lawn, IL 60453-2600 2005-12-08

Office Location

Street Address MEDICAL CENTER BLVD
City WINSTON SALEM
State NC
Zip Code 27157-0001

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811990815 Gary Lee Ray Registered Nurse Medical Center Blvd, Winston Salem, NC 27157-0001 2005-05-23
1881295418 Alan Townes Grizzard Nurse Practitioner Medical Center Blvd, Winston Salem, NC 27157-0001 2020-11-02
1003421751 Nicholas Ryan Tuttle Nurse Anesthetist, Certified Registered Medical Center Blvd, Winston Salem, NC 27157-0001 2020-09-10
1356956122 Caitlin Marie Clement Nurse Anesthetist, Certified Registered Medical Center Blvd, Winston Salem, NC 27103 2020-09-09
1376154591 Lori Sansone Flores Nurse Practitioner Medical Center Blvd, Winston Salem, NC 27157-0001 2020-08-11
1821609330 Hannah Carey Walker Physician Assistant Medical Center Blvd, Winston Salem, NC 27157-0001 2020-08-10
1447876883 Raveena Mahesh Chhabria Student in an Organized Health Care Education/Training Program Medical Center Blvd, Winston Salem, NC 27157-0001 2020-06-22
1780205930 Jason Chin Student in an Organized Health Care Education/Training Program Medical Center Blvd, Winston Salem, NC 27157-1087 2020-04-29
1972122885 Bryanna Dean Vesely Student in an Organized Health Care Education/Training Program Medical Center Blvd, Winston Salem, NC 27157-0001 2020-04-10
1679102909 Ameen Barghi Student in an Organized Health Care Education/Training Program Medical Center Blvd, Winston Salem, NC 27157-2803 2020-04-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255960241 Alexandra Marie Balmaceda Student in an Organized Health Care Education/Training Program Wake Forest Baptist Medical Center Pathology Dept, #1 Medical Center Blvd., Winston-salem, NC 27157 2020-04-02
1164916680 Jorie Elizabeth Gatts Student in an Organized Health Care Education/Training Program Wake Forest Baptist Medical Department of Pediatrics, Winston Salem, NC 27157 2018-06-18
1932606555 Alexi Rae Ellington Webb Student in an Organized Health Care Education/Training Program Wake Forest School of Medicine, Dept of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 2018-04-10
1851896674 Wasim Muhammad Student in an Organized Health Care Education/Training Program Wake Forest School of Medicine Dept. of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 2018-03-25
1336643535 Phillip Martin Kostelic Student in an Organized Health Care Education/Training Program Anesthesiology - Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-salem, NC 27157 2018-03-21
1831693324 Aleah Bond Student in an Organized Health Care Education/Training Program Anesthesiology Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-salem, NC 27157 2018-03-20
1134644859 Ilan Binyamin Klein Urology Wake Forest Baptist Health, Department of Urology, Medical Center Boulevard, Winston-salem, NC 27157 2017-08-03
1023467529 Edward John Doyle IIi Student in an Organized Health Care Education/Training Program Wake Forest School of Medicine Dept. of Otolaryngology, Watlington Hall 4th Fl. Medical Center Boulevard, Winston-salem, NC 27157 2016-06-07
1477917888 Jordan Mae Burner Student in an Organized Health Care Education/Training Program Graduate Medical Education Office, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-salem, NC 27157 2016-04-12
1174900476 Kate Elise Winterbottom Speech-Language Pathologist 4 Janeway Medical Center Blvd, Hearing and Speech, Winston Salem, NC 27157 2015-05-06
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1629692439 Julie Anne Augustine Physician Assistant 718 S Green St, Winston Salem, NC 27101-5112 2020-06-08
1932674090 Erin Baxter Caldwell Physician Assistant 2953 Buena Vista Rd, Winston Salem, NC 27106-5724 2018-10-04
1376054106 Tara Mckenzie Physician Assistant 1 Medical Center Blvd Hosptial Medicine, Winston Salem, NC 27157-0001 2017-10-19
1154866382 Camilla Potts Leonard Physician Assistant 503 Thurston St, Winston Salem, NC 27103-1609 2016-12-26
1427591379 Darrell Justin Ratcliffe Physician Assistant 1500 W Academy St, Winston Salem, NC 27103-3849 2016-11-27
1881825917 Mark Elno Archambault Physician Assistant Department of Physician Assistant Studies, Medical Center Blvd, Winston Salem, NC 27157-1006 2009-08-06
1659519551 John Clifton Harper Jr. Physician Assistant 206 W Clemmonsville Rd, Winston Salem, NC 27127-5124 2009-01-30
1710070602 John Joseph Dewar Sr. Physician Assistant 1399 Ashleybrook Ln Ste 100, Winston Salem, NC 27103-2961 2006-10-02
1871515866 Beth Gurley Physician Assistant 765 Highland Oaks Dr, Suite 100, Winston Salem, NC 27103-7101 2006-07-25
1801845722 Mark A Pane Physician Assistant 3333 Brookview Hills Blvd Ste 104, Winston Salem, NC 27103-5661 2006-05-08
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Competitor

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City WINSTON SALEM
Zip Code 27157

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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