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:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10033 STRIKE THE GOLD LN
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-8084
Mailing Address - Country:US
Mailing Address - Phone:704-989-4760
Mailing Address - Fax:
Practice Address - Street 1:10033 STRIKE THE GOLD LN
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-8084
Practice Address - Country:US
Practice Address - Phone:704-989-4760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant