Provider Demographics
NPI:1710034194
Name:HOLLINGER, EDWARD JOHN JR (PA-C)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:JOHN
Last Name:HOLLINGER
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 RAHNCLIFF CT
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-3404
Mailing Address - Country:US
Mailing Address - Phone:651-686-6442
Mailing Address - Fax:651-686-0789
Practice Address - Street 1:1970 RAHNCLIFF CT
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3404
Practice Address - Country:US
Practice Address - Phone:651-686-6442
Practice Address - Fax:651-686-0789
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9150363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical