Healthcare Provider Details

I. General information

NPI: 1508006958
Provider Name (Legal Business Name): JOLENE L HOLDEN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOLENE L STEMMANN

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 1ST ST SW
ROCHESTER MN
55905-0001
US

IV. Provider business mailing address

PO BOX 860912
MINNEAPOLIS MN
55486-0912
US

V. Phone/Fax

Practice location:
  • Phone: 507-284-2511
  • Fax:
Mailing address:
  • Phone: 507-284-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number6207-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR 156579-3
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number220874
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0009
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: