Healthcare Provider Details

I. General information

NPI: 1578971990
Provider Name (Legal Business Name): MOLLY HOLSTEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 07/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 NORMAL BLVD SUITE 201
LINCOLN NE
68506-5261
US

IV. Provider business mailing address

1123 N 9TH ST
BEATRICE NE
68310-2041
US

V. Phone/Fax

Practice location:
  • Phone: 402-261-4017
  • Fax: 402-261-4137
Mailing address:
  • Phone: 402-228-3386
  • Fax: 402-228-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: