Holland, Jack

Holland, Jack is an individual health care provider with primary practice located at Heber Valley Hospital 1485 Us-40, Heber City UT 84032. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Holland, Jack can be contacted via phone (435) 654-2500.

Contact Information

Primary practice address
Heber Valley Hospital 1485 Us-40 Heber City UT 84032
Phone: (435) 654-2500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 161328 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 821399 Nevada
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 053081 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 9809402-4406 Utah

Profile Details

NPI number 1699755231
LBN Legal business name Holland, Jack
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Oct 26th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699755231 NPPES
North Carolina MEDICAID 8051521

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