Provider Demographics
NPI:1215340872
Name:HOLLIS, LACHINA MOORE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LACHINA
Middle Name:MOORE
Last Name:HOLLIS
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:DR
Other - First Name:LACHINA
Other - Middle Name:MOORE
Other - Last Name:HOLLIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP
Mailing Address - Street 1:509 N ELAM AVE
Mailing Address - Street 2:SUITE 3E
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1129
Mailing Address - Country:US
Mailing Address - Phone:336-832-1970
Mailing Address - Fax:336-832-1988
Practice Address - Street 1:107 CORPORATE BLVD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169
Practice Address - Country:US
Practice Address - Phone:803-832-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF0614018363LA2100X
SC29532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care