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NPI Code Detail

MEDICARE: JACOB LEE HOLMQUIST FNP

MEDICARE: JACOB LEE HOLMQUIST FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner1000909-NPCO

General Provider Information

NPI Number : 1588502660
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB LEE HOLMQUIST FNP
Provider Business Mailing Address
First Line : 1300 MAIN ST
Second Line :
City : WINDSOR
State : CO
Zip : 80550-5989
Country : US
Telephone Number : 970-686-5646
Fax Number :
Provider Business Practice Location Address
First Line : 1300 MAIN ST
Second Line :
City : WINDSOR
State : CO
Zip : 80550-5989
Country : US
Telephone Number : 970-686-5646
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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