Provider Demographics
NPI:1578665287
Name:HOLSING, TRACY (CRNA)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:HOLSING
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8426 W BIRCH RD
Mailing Address - Street 2:
Mailing Address - City:CLATONIA
Mailing Address - State:NE
Mailing Address - Zip Code:68328-8402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 H ST
Practice Address - Street 2:
Practice Address - City:FAIRBURY
Practice Address - State:NE
Practice Address - Zip Code:68352-1119
Practice Address - Country:US
Practice Address - Phone:402-729-3351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE50171367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered