Provider Demographics
NPI:1689258436
Name:HOLLINS, KENYA
Entity Type:Individual
Prefix:
First Name:KENYA
Middle Name:
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 1:500 SHADY MAGNOLIA CT
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-3348
Mailing Address - Country:US
Mailing Address - Phone:936-207-0078
Mailing Address - Fax:
Practice Address - Street 1:500 SHADY MAGNOLIA CT
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-3348
Practice Address - Country:US
Practice Address - Phone:936-207-0078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator