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General NPI Number Information
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NPI Number | 1548569023
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Entity Type | Individual
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Provider Name | RULON B HOLMAN CRNA
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Gender | Male
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Dates
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Enumeration Date | 03/23/2011
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Last Update Date | 03/23/2011
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Provider Practice Location Address
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Address Line | 2100 N MARTIN LUTHER KING JR BLVD
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City | CLOVIS
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State | NM
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Zip | 88101
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Country | US
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Telephone | 575-769-7152
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 98567
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City | LAS VEGAS
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State | NV
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Zip | 89193-8567
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Country | US
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Telephone | 915-779-1716
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CRNA-01137
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License Number State | NM
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