Provider Demographics
NPI:1235703323
Name:HOLLINS, TAMEKA ELAINE
Entity Type:Individual
Prefix:
First Name:TAMEKA
Middle Name:ELAINE
Last Name:HOLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 SHIRLEY AVE
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2657
Mailing Address - Country:US
Mailing Address - Phone:314-240-9387
Mailing Address - Fax:
Practice Address - Street 1:432 SHIRLEY AVE
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-2657
Practice Address - Country:US
Practice Address - Phone:314-240-9387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)