Healthcare Provider Details

I. General information

NPI: 1922029792
Provider Name (Legal Business Name): JANIS CAROL HOLIWELL RN, MN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 SW GAGE BLVD
TOPEKA KS
66622-0001
US

IV. Provider business mailing address

7300 SW AMBASSADOR PL
TOPEKA KS
66610-1598
US

V. Phone/Fax

Practice location:
  • Phone: 785-350-3111
  • Fax: 785-350-4385
Mailing address:
  • Phone: 785-478-0436
  • Fax: 785-477-8053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number13-31884-032
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: