Basic Information
| Provider Information | |||||||||
| NPI: | 1245520279 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDHOLM | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | BREEANN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | EKEMA | ||||||||
| OtherFirstName: | ERIN | ||||||||
| OtherMiddleName: | BREEANN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5055 HIGH POINTE DR | ||||||||
| Address2: | |||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325051830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592807678 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 125 CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | VIDALIA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 304744770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9125388484 | ||||||||
| FaxNumber: | 9125388665 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2011 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 04/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 81304 | GA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | ME121336 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.