Doctor Name: | JUSTIN HOLLAND |
NPI Number: | 1275977076 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPN |
License Number: | LP60230777 |
Business Practice Address: | 13820 19th Ave Ne Tulalip, WA - 982716706 |
Business Phone Number: | 4252318545 |
Business Fax Number: | |
Mailing Address: | 6724 73rd St Ne, MARYSVILLE |
State: | WA |
Postal Code: | 982707713 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/23/2013 |
NPI Last Update Date: | 04/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | LP60230777 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |