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General NPI Number Information
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NPI Number | 1669416079
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Entity Type | Individual
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Provider Name | HOLLY JENNIFER JASKIERNY D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 05/12/2021
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Provider Practice Location Address
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Address Line | 1620 GENESYS PKWY
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City | GRAND BLANC
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State | MI
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Zip | 48439-2560
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Country | US
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Telephone | 810-606-7190
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Fax | 810-606-7186
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Provider Business Mailing Address
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Address Line | 1620 GENESYS PKWY
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City | GRAND BLANC
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State | MI
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Zip | 48439-2560
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Country | US
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Telephone | 810-606-7190
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Fax | 810-606-7186
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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 | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 5101015227
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License Number State | MI
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