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Individual
MS. MARY ANN HOLEM
Active
Individual
MS. MARY ANN HOLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209008856
IL
363LF0000X
Family Nurse Practitioner
Primary
209008856
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209008856
STATE LICENSE
IL
Enumeration date
06/09/2011
Last updated
10/19/2018
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