| Doctor Name: | HOLLY HABERMAN |
| NPI Number: | 1083073597 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | XXXXX |
| Business Practice Address: | 409 Summit St Suite # 3400 Yankton, SD - 570783734 |
| Business Phone Number: | 6052600310 |
| Business Fax Number: | |
| Mailing Address: | 55149 Knox Ave, CROFTON |
| State: | NE |
| Postal Code: | 687304144 |
| Phone Number: | 4023882374 |
| Fax Number: | |
| NPI Enumeration Date: | 02/12/2016 |
| NPI Last Update Date: | 02/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | XXXXX |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |