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Individual

JOLI HALLOWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
717 N 190TH PLZ, STE. 3100, ELKHORN, NE 68022-3913
(402) 815-1325
(402) 815-2020
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1985
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025837400
NE
05
10026480100
NE
05
47068731742
NE
Enumeration date
01/26/2016
Last updated
03/06/2019
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