Provider Demographics
NPI:1578558375
Name:HOLBEIN, VIRGINIA IRENE (MSN, CRNP-C)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:IRENE
Last Name:HOLBEIN
Suffix:
Gender:F
Credentials:MSN, CRNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BRIAN DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-9795
Mailing Address - Country:US
Mailing Address - Phone:724-775-2612
Mailing Address - Fax:
Practice Address - Street 1:2620 CONSTITUTION BLVD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1278
Practice Address - Country:US
Practice Address - Phone:724-847-4755
Practice Address - Fax:724-843-1554
Is Sole Proprietor?:No
Enumeration Date:2005-09-18
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN252382L163W00000X
OHRN189150163W00000X
PAVP005006B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS64304Medicare UPIN