Provider Demographics
NPI:1578209326
Name:BUCHHOLZ, JOELLE (NP)
Entity Type:Individual
Prefix:
First Name:JOELLE
Middle Name:
Last Name:BUCHHOLZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19404 OAKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-4232
Mailing Address - Country:US
Mailing Address - Phone:402-440-6148
Mailing Address - Fax:
Practice Address - Street 1:312 OLSON DR STE 101
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2981
Practice Address - Country:US
Practice Address - Phone:402-933-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE113780363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner