Provider Demographics
NPI:1578108304
Name:SIENKIEWICZ, HOLLY (RN)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:SIENKIEWICZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 VIEW VISTA DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-3528
Mailing Address - Country:US
Mailing Address - Phone:406-222-0448
Mailing Address - Fax:
Practice Address - Street 1:102 VIEW VISTA DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-3528
Practice Address - Country:US
Practice Address - Phone:406-222-0448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT73401163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool