Provider Demographics
NPI:1083283329
Name:HOLLENBECK, NATHAN VERAL (NP)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:VERAL
Last Name:HOLLENBECK
Suffix:
Gender:M
Credentials:NP
Other - Prefix:MR
Other - First Name:NATE
Other - Middle Name:VERAL
Other - Last Name:HOLLENBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5555
Mailing Address - Country:US
Mailing Address - Phone:405-618-1586
Mailing Address - Fax:
Practice Address - Street 1:620 S MADISON ST STE 209A
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-7270
Practice Address - Country:US
Practice Address - Phone:580-233-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0101409363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily