Doctor Name: | MS. AMY HOLMGREN |
NPI Number: | 1841636503 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, BSN, MPH |
License Number: | 041244670 |
Business Practice Address: | 36633 N Stanton Point Rd Ingleside, IL - 600418444 |
Business Phone Number: | 8473778967 |
Business Fax Number: | |
Mailing Address: | 36633 N Stanton Point Rd, INGLESIDE |
State: | IL |
Postal Code: | 600418444 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/21/2013 |
NPI Last Update Date: | 05/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 041244670 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |