Marcel Leon Hollis, RD

Individual provider Active NPI Registered Dietitian · Kotzebue, AK

NPI 1982329322 · NPPES record last updated Oct 7, 2022

Key facts

NPI
1982329322
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
199720 (AK)
Practice address
436 5TH Ave
Kotzebue, AK 99752
Phone
(907) 442-3321
NPI assigned
Oct 7, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
199720AKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Maniilaq Association Past
since Oct 9, 2022
Accepting new patients
Maniilaq Association Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 199720 AK Yes

Addresses

Primary practice location

436 5TH Ave
Kotzebue, AK 99752

Mailing address

PO Box 256
Kotzebue, AK 99752-0256
Phone (907) 442-7323

Other names

  • Marcel Leon Hollis Professional name

Other providers in Kotzebue, AK

All providers in Kotzebue, AK · Registered Dietitian in Alaska

Sources for this page

Verify at the official NPI Registry.