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NPI Code Detail

MEDICARE: LINDA ANN HOLLERN NP

MEDICARE: LINDA ANN HOLLERN NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WD0400XDiabetes Educator Registered Nurse4704134053MI
2363LA2200XAdult Health Nurse Practitioner4704134053MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548256985
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA ANN HOLLERN NP
Provider Business Mailing Address
First Line : 1 GENESYS PKWY
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-8065
Country : US
Telephone Number : 810-606-5632
Fax Number :
Provider Business Practice Location Address
First Line : 1 GENESYS PKWY
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-8065
Country : US
Telephone Number : 810-606-5632
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 12/30/2015

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