Physician Compare National (NPI:1306926274)

HEALTHCARE PROVIDER: JOANNE MARIE HOLLAND M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1306926274
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3870559388
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20041207000323
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HOLLAND
	Individual professional last name
Provider First Name	JOANNE
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	FAMILY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	FAMILY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	117 3RD ST
	Group Practice or individual's line 1 address
City	DRAIN
	Group Practice or individual's city
State	OR
	Group Practice or individual's state
Zip Code	974350210
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5418362371
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	381301
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y