Provider Demographics
NPI:1356000608
Name:HOLLIE, PAULA NICOLE (RMP)
Entity Type:Individual
Prefix:MISS
First Name:PAULA
Middle Name:NICOLE
Last Name:HOLLIE
Suffix:
Gender:F
Credentials:RMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8404 NUNLEY DR APT F
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-4411
Mailing Address - Country:US
Mailing Address - Phone:410-804-1135
Mailing Address - Fax:
Practice Address - Street 1:8404 NUNLEY DR APT F
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-4411
Practice Address - Country:US
Practice Address - Phone:410-804-1135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR03434225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist