Individual
JACQUELYN H HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
801 FOREST RIDGE DR STE 104, BEDFORD, TX 76022-7240
(405) 596-2830
Mailing address
PO BOX 1744, BEDRORD, TX 76022
(405) 596-2830
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
890576
TX
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
890576
TX
Other
Enumeration date
08/18/2020
Last updated
11/30/2022
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