Individual
REGINA HOLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
63318 ISTHMUS HEIGHTS RD, COOS BAY, OR 97420-8286
(479) 979-5438
Mailing address
63318 ISTHMUS HEIGHTS RD, COOS BAY, OR 97420-8286
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201242896RN
OR
163W00000X
Registered Nurse
201242986RN
OR
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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