Active NPI
Jeffrey Hollis II
- Licensed Practical Nurse
- Monroe, LA
National Provider Identifier
1558074948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 20100479
- Practice address
- 1808 Glenmar Ave
Monroe, LA 71201-4932 - Phone
- (318) 327-5344
- NPI assigned
- Dec 30, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 20100479 | LA | Primary |
Addresses
Primary practice location
1808 Glenmar Ave
Monroe, LA 71201-4932
Mailing address
1808 Glenmar Ave
Monroe, LA 71201-4932
Phone (318) 327-5344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20100479 | LA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672358400000",
"number": "1558074948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 GLENMAR AVE",
"city": "MONROE",
"state": "LA",
"postal_code": "712014932",
"telephone_number": "318-327-5344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 GLENMAR AVE",
"city": "MONROE",
"state": "LA",
"postal_code": "712014932",
"telephone_number": "318-327-5344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLIS",
"first_name": "JEFFREY",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-30",
"last_updated": "2022-12-30",
"certification_date": "2022-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "LA",
"license": "20100479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.