Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | A088382 | IA |
NPI | 1013163427 |
---|---|
Provider Name | Jodi F Holloway |
First Address | Newton, IA 50208-3122 |
Second Address | Newton, IA 50208-2015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2008 |
Last Update Date | 04/02/2016 |