Individual
LAURA HOLLENBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01060805
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000374263
ANTHEM
IN
05
—
200530750
—
IN
01
—
Q0340433
SHO
IN
Enumeration date
12/29/2005
Last updated
05/28/2009
Update your record
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