Elizabeth Holder
Individual provider Active NPI Pharmacist · Waveland, MS
NPI 1164296372 · NPPES record last updated Nov 8, 2023
Key facts
- NPI
- 1164296372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- E-101327 (MS)
- Practice address
- 460 US-90
Waveland, MS 39576 - Phone
- (228) 467-4717
- NPI assigned
- Nov 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-101327 | MS | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
1835P0018X | E-101327 | MS | |
| Pharmacist | 183500000X | E-101327 | MS | Yes |
Addresses
Primary practice location
460 US-90
Waveland, MS 39576
Mailing address
5145 Pine Ave
Pearlington, MS 39572-7723
Other providers in Waveland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.