Healthcare Provider Details

I. General information

NPI: 1295793297
Provider Name (Legal Business Name): MARTHA MARY HOLMQUIST DNP, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20350 COUNTY ROAD 39
GLENWOOD MN
56334-4004
US

IV. Provider business mailing address

PO BOX 265
GLENWOOD MN
56334-0265
US

V. Phone/Fax

Practice location:
  • Phone: 320-760-6925
  • Fax: 320-239-2623
Mailing address:
  • Phone: 320-760-6925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number8946
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: