Individual
VICTORIA S HOLDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4311 E 65TH S, IDAHO FALLS, ID 83406-8127
(208) 970-2027
Mailing address
4311 E 65TH S, IDAHO FALLS, ID 83406-8127
(208) 970-2027
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
57304
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
57304
ID
Other
Enumeration date
03/29/2021
Last updated
08/28/2023
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