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General NPI Number Information
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NPI Number | 1619929437
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Entity Type | Individual
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Provider Name | JEAN A HOLTHAUS CNP
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Gender | Female
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 4015 EXECUTIVE PARK DR STE 406
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City | CINCINNATI
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State | OH
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Zip | 45241-4017
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Country | US
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Telephone | 513-569-6747
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Fax | 513-569-6988
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Provider Business Mailing Address
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Address Line | PO BOX 632778
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City | CINCINNATI
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State | OH
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Zip | 45263-2778
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Country | US
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Telephone | 513-891-7574
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Fax | 513-793-1032
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NP-06838
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License Number State | OH
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