Individual
DR. JONATHAN HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
803 S MAIN ST STE 210, MOSCOW, ID 83843-2695
(509) 228-1000
(509) 252-9300
Mailing address
PO BOX 500409, SAIPAN, MP 96950-0409
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R190104
MP
163W00000X
Registered Nurse
RN208920
AZ
363L00000X
Nurse Practitioner
Primary
74509
ID
363L00000X
Nurse Practitioner
APRN-4900
HI
363LF0000X
Family Nurse Practitioner
248356
AZ
Other
Enumeration date
10/02/2020
Last updated
04/25/2025
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