Provider Demographics
NPI:1235906439
Name:PARDIKES, HOLIN ALEXIS (NP)
Entity Type:Individual
Prefix:
First Name:HOLIN
Middle Name:ALEXIS
Last Name:PARDIKES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31208 BECK RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-1022
Mailing Address - Country:US
Mailing Address - Phone:248-960-0934
Mailing Address - Fax:
Practice Address - Street 1:31208 BECK RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-1022
Practice Address - Country:US
Practice Address - Phone:248-960-0934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704322671363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily