Provider Demographics
NPI:1861668303
Name:BURKHOLDER, HOLLY GRIFFIN (PA-C)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:GRIFFIN
Last Name:BURKHOLDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:LEIGH
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HOLLY GRIFFIN HONG
Mailing Address - Street 1:4700 SANDOZ DR
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-8143
Mailing Address - Country:US
Mailing Address - Phone:252-234-2436
Mailing Address - Fax:252-234-2470
Practice Address - Street 1:4700 SANDOZ DR
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-8143
Practice Address - Country:US
Practice Address - Phone:252-234-2436
Practice Address - Fax:252-234-2470
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01220363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant