Individual
MATTHEW E HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
540 JETTS DRIVE, JACKSON, KY 41339
(606) 666-6000
(606) 666-6102
Mailing address
540 JETTS DRIVE, JACKSON, KY 41339
(606) 666-6000
(606) 666-6102
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1109901
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000492112
BCBS
KY
05
—
7100021760
—
KY
Enumeration date
08/31/2006
Last updated
06/26/2008
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