Provider Demographics
NPI:1568192185
Name:HOLLIS, CARMEN MARIE (NNP-BC)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:MARIE
Last Name:HOLLIS
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6467 ALIBI CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-3876
Mailing Address - Country:US
Mailing Address - Phone:719-271-2000
Mailing Address - Fax:
Practice Address - Street 1:6001 E WOODMEN RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2601
Practice Address - Country:US
Practice Address - Phone:719-571-8450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1633167163WN0002X
COAPN.0997751-NP363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care