| Doctor Name: | PAMELA HOLLER |
| NPI Number: | 1497742290 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 102839 |
| Business Practice Address: | 1600 Specht Point Rd Suite 127 Ft Collins, CO - 805254311 |
| Business Phone Number: | 9704937733 |
| Business Fax Number: | 9704938745 |
| Mailing Address: | 1600 Specht Point Rd, Suite 127 FT COLLINS |
| State: | CO |
| Postal Code: | 805254311 |
| Phone Number: | 9704937733 |
| Fax Number: | 9704938745 |
| NPI Enumeration Date: | 10/05/2005 |
| NPI Last Update Date: | 04/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 102839 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |