Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 0101048833 | VA |
N | 208200000X | Surgeon | 010148833 | VA |
N | 208600000X | Surgeon | 010148833 | VA |
NPI | 1992790406 |
---|---|
Provider Name | Ms. Jann L Holwick |
First Address | Williamsburg, WV 24991 |
Second Address | Christiansburg, VA 24073 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 05/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010042470 | (05) | VA |
A45880 | (02) | VA |