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MR. HENRICK KARL HOLMBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
CORNER OF NR 7 & NR 12, FORT DEFIANCE, AZ 86504
(928) 729-8581
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-8581

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN198338
AZ
163WC0200X
Critical Care Medicine Registered Nurse
1-138207
AL

Other

Enumeration date
10/27/2021
Last updated
10/27/2021
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