Provider Demographics
NPI:1730486358
Name:HOLDREN, SHEILA (LPN RDCS)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:HOLDREN
Suffix:
Gender:F
Credentials:LPN RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 16TH ST
Mailing Address - Street 2:
Mailing Address - City:SILVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61282-2624
Mailing Address - Country:US
Mailing Address - Phone:563-508-1661
Mailing Address - Fax:
Practice Address - Street 1:505 16TH ST
Practice Address - Street 2:
Practice Address - City:SILVIS
Practice Address - State:IL
Practice Address - Zip Code:61282-2624
Practice Address - Country:US
Practice Address - Phone:563-508-1661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
110645246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography