Healthcare Provider Details

I. General information

NPI: 1578558375
Provider Name (Legal Business Name): VIRGINIA IRENE HOLBEIN MSN, CRNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2005
Last Update Date: 01/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 CONSTITUTION BLVD
BEAVER FALLS PA
15010-1278
US

IV. Provider business mailing address

101 BRIAN DR
BEAVER PA
15009-9795
US

V. Phone/Fax

Practice location:
  • Phone: 724-847-4755
  • Fax: 724-843-1554
Mailing address:
  • Phone: 724-775-2612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN252382L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN189150
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberVP005006B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: