Provider Demographics
NPI:1629097324
Name:HOLLON, LYNNETTE D (NP)
Entity Type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:D
Last Name:HOLLON
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 1:8440 WALNUT HILL LN STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3814
Mailing Address - Country:US
Mailing Address - Phone:214-328-3566
Mailing Address - Fax:214-328-0798
Practice Address - Street 1:8440 WALNUT HILL LN STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3814
Practice Address - Country:US
Practice Address - Phone:214-328-3566
Practice Address - Fax:214-328-0798
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX558831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042598502Medicaid
TX042598501Medicaid
TX042598503Medicaid
TX042598503Medicaid
TX042598502Medicaid
TX042598501Medicaid
TXTXB122085Medicare PIN