Individual
JEAN A HOLTHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4015 EXECUTIVE PARK DR, STE 406, CINCINNATI, OH 45241-4017
(513) 569-6747
(513) 569-6988
Mailing address
PO BOX 632778, CINCINNATI, OH 45263-2778
(513) 891-7574
(513) 793-1032
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP-06838
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2592494
—
OH
01
—
P00287513
RAILROAD MEDICARE
OH
Enumeration date
05/17/2006
Last updated
11/30/2007
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