Provider Demographics
NPI:1225576119
Name:HOLLOWAY, KATHERINE CANOY (PA)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:CANOY
Last Name:HOLLOWAY
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Gender:F
Credentials:PA
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Mailing Address - Street 1:101 E W T HARRIS BLVD
Mailing Address - Street 2:SUITE 3109
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-3485
Mailing Address - Country:US
Mailing Address - Phone:330-445-4361
Mailing Address - Fax:330-451-4197
Practice Address - Street 1:10628 PARK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8407
Practice Address - Country:US
Practice Address - Phone:704-667-1147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
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Provider Licenses
StateLicense IDTaxonomies
NC001007075363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant