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
Phone: (801) 344-4311
Fax: (801) 344-4225
Website:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003852765 | NPPES |
| Utah | MEDICAID | 09352 |
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