Provider Demographics
NPI:1467579821
Name:HOLTHAUS, ROXANNE MARIE (FNP)
Entity Type:Individual
Prefix:MS
First Name:ROXANNE
Middle Name:MARIE
Last Name:HOLTHAUS
Suffix:
Gender:F
Credentials:FNP
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Other - Credentials:
Mailing Address - Street 1:1 COLLEGE CIR
Mailing Address - Street 2:LADERDALE CENTER FOR STUDENT HEALTH AND COUNSELING
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-1401
Mailing Address - Country:US
Mailing Address - Phone:585-245-5736
Mailing Address - Fax:585-245-5744
Practice Address - Street 1:1 COLLEGE CIR
Practice Address - Street 2:LADERDALE CENTER FOR STUDENT HEALTH AND COUNSELING
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1401
Practice Address - Country:US
Practice Address - Phone:585-245-5736
Practice Address - Fax:585-245-5744
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY332170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily