Holland, Renae

Holland, Renae is an individual health care provider with primary practice located at 1300 E Center St Utah State Hospital, Provo UT 84606-3554. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Holland, Renae can be contacted via phone (801) 344-4311.

Contact Information

Primary practice address
1300 E Center St Utah State Hospital Provo UT 84606-3554
Fax: (801) 344-4225
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 1790421205 Utah

Profile Details

NPI number 1003852765
LBN Legal business name Holland, Renae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003852765 NPPES
Utah MEDICAID 09352

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