HOLLY L EDMONDS (NPI# 1669611034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669611034 |
| Entity Type | Individual |
| Full Name | HOLLY L EDMONDS |
| Credential | PA-C |
| Practice Address |
1014 Saint Clair Blvd Suite 1000 Gonzales LA 70737-5023 |
| Mailing Address |
5445 La Sierra Dr Suite 410 Dallas TX 75231-4139 |
| Practice Telephone | 2257432333 |
| Mailing Telephone | 2143821909 |
| Mailing Fax Number | 2143821903 |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2009-02-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
A10599 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | LOUISIANA LICENSE | 6347958 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326244831 | Holly Dickson Edmonds | Dermatology | 1800 Howell Mill Rd Nw, Suite 680, Atlanta, GA 30318-2538 | 2007-06-22 |
| Street Address |
1014 SAINT CLAIR BLVD SUITE 1000 |
| City | GONZALES |
| State | LA |
| Zip Code | 70737-5023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235172651 | Rahil Devendra Shah | Internal Medicine | 1014 Saint Clair Blvd, Ste 3020, Gonzales, LA 70737-5023 | 2006-06-14 |
| 1891018867 | Margaret D. Mahler | Nurse Practitioner | 1014 Saint Clair Blvd, Suite 3030, Gonzales, LA 70737-5023 | 2010-03-05 |
| 1245560036 | Jesse D. Lambert | Psychologist | 1014 Saint Clair Blvd, Suite 1000, Gonzales, LA 70737-5023 | 2009-12-30 |
| 1861635609 | Elizabeth Ann Bollinger | Internal Medicine | 1014 Saint Clair Blvd, Gonzales, LA 70737-5023 | 2009-04-09 |
| 1932376332 | Elena M Campbell | Urology | 1014 Saint Clair Blvd, Suite 3000, Gonzales, LA 70737-5023 | 2008-05-14 |
| 1871772202 | W B Kimbrough IIi | Surgery | 1014 Saint Clair Blvd, Suite 3015, Gonzales, LA 70737-5023 | 2007-11-01 |
| 1982892816 | Geoffrey Michael Fraiche | Obstetrics & Gynecology | 1014 Saint Clair Blvd, Suite 3030, Gonzales, LA 70737-5023 | 2007-10-04 |
| 1649467580 | James Newman Williams | Surgery | 1014 Saint Clair Blvd, Suite 3015, Gonzales, LA 70737-5023 | 2007-09-25 |
| 1215146477 | Dawn Sharp | Otolaryngology | 1014 Saint Clair Blvd, Suite 2010, Gonzales, LA 70737-5023 | 2007-05-22 |
| 1821202557 | Amy E Ocmand | Surgery | 1014 Saint Clair Blvd, Suite 3015, Gonzales, LA 70737-5023 | 2007-05-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461593 | Scott G Petrie Md Apmc | Non-Pharmacy Dispensing Site | 1014 West St Clare Boulevard, Ste 1020, Gonzales, LA 70737 | 2020-09-15 |
| 1407461981 | Bryant Louis Bourgeois | Dentist | 13317 N Burnside, Gonzales, LA 70737 | 2020-09-11 |
| 1821612631 | Kene Anje Hamilton | Behavioral Analyst | 1028 East Worthy Street, Gonzales, LA 70737 | 2020-06-08 |
| 1801428636 | Mercedes Francis | Behavior Technician | 1023 E W Worthy Rd, Gonzales, LA 70737 | 2020-02-10 |
| 1407347586 | Functional Dme | Prosthetic/Orthotic Supplier | 219 W. Eastbank St., Ste B, Gonzales, LA 70737 | 2018-05-23 |
| 1235631789 | Transporting On Purpose | Non-emergency Medical Transport (VAN) | 42148 Conifer Drive, Gonzales, LA 70737 | 2018-03-01 |
| 1215453121 | Michelle Fuller Harris | Social Worker | 39094 N Angelle Ct, Gonzales, LA 70737 | 2017-08-22 |
| 1215452529 | Lani Litchfield | Specialist/Technologist | 13341 W. Mill Grove Dr, Gonzales, LA 70737 | 2017-08-08 |
| 1326569369 | Tyler Joshua Turner | Counselor | 1923 South Edwards, Gonzales, LA 70737 | 2017-06-29 |
| 1518408046 | Margaret Madere | Social Worker | 2827 S Ruby Street, Gonzales, LA 70737 | 2017-03-16 |
| Find all providers in zip 70737 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316100381 | David Henry Sepulveda | Physician Assistant | 2647 S Saint Elizabeth Blvd Ste 219, Gonzales, LA 70737-5020 | 2008-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104423151 | Osler Surgical Services LLC | Physician Assistant | 929 Tezcucco Ct, Covington, LA 70433-8157 | 2020-10-02 |
| 1841841855 | Kasie Danielle Nelson | Physician Assistant | 8585 Picardy Ave Ste 514, Baton Rouge, LA 70809-3748 | 2019-09-23 |
| 1013575018 | Louisiana Surgical Assist, L.L.C. | Physician Assistant | 1374 Knollwood Dr, Baton Rouge, LA 70808-8647 | 2019-06-04 |
| 1285290098 | Nicole Michelle Toups | Physician Assistant | 2551 Greenwood Rd Ste 311, Shreveport, LA 71103-3981 | 2019-05-16 |
| 1437712114 | Karley Marie Boagni | Physician Assistant | 3434 Prytania St Ste 410, New Orleans, LA 70115-3574 | 2019-04-17 |
| 1144793175 | Picardy Surgical Assist II, L.L.C. | Physician Assistant | 7425 Bocage Blvd, Baton Rouge, LA 70809-1141 | 2019-01-02 |
| 1952874984 | Perkins Surgical Assist II, L.L.C. | Physician Assistant | 18611 Saint Andrews Ct W, Prairieville, LA 70769-3251 | 2019-01-02 |
| 1578033825 | Picardy Surgical Assist, L.L.C. | Physician Assistant | 7301 Hennessy Blvd Ste 300, Baton Rouge, LA 70808-4794 | 2018-11-29 |
| 1609362177 | Harley Ann Augustine | Physician Assistant | 3001 Division St, Metairie, LA 70002-5854 | 2018-07-07 |
| 1750880134 | Robert Gomann Genovese II | Physician Assistant | 1233 Wayne Gilmore Cir Ste 250a, Opelousas, LA 70570-6405 | 2018-02-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.