Basic Information
Provider Information
NPI: 1316948151
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLLMAN
FirstName: CHARLOTTE
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7373 PERKINS ROAD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 70808
CountryCode: US
TelephoneNumber: 2257694044
FaxNumber:  
Practice Location
Address1: 7373 PERKINS ROAD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 70808
CountryCode: US
TelephoneNumber: 2257694044
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/02/2005
LastUpdateDate: 03/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X014131LAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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