1609994565 NPI number — MRS. CHRISTINE MARY HOLLMAN OTR

Table of content: MRS. CHRISTINE MARY HOLLMAN OTR (NPI 1609994565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609994565 NPI number — MRS. CHRISTINE MARY HOLLMAN OTR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLLMAN
Provider First Name:
CHRISTINE
Provider Middle Name:
MARY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BOLLE
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1609994565
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 1ST ST SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55905-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-284-2511
Provider Business Mailing Address Fax Number:
888-624-3107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 1ST ST SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-284-2511
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  103007 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com