| NPI | 1659130888 |
|---|---|
| Former Name | COLLEEN HOLLAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 15152) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 1515233) |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-05-09 |