Provider Demographics
NPI:1932295367
Name:HOLLE, JOANNA LEA (APRN-BC)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:LEA
Last Name:HOLLE
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:LEA
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901A SPICEWOOD SPRINGS RD
Mailing Address - Street 2:STE. 102
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8723
Mailing Address - Country:US
Mailing Address - Phone:737-226-6700
Mailing Address - Fax:737-226-6777
Practice Address - Street 1:3901A SPICEWOOD SPRINGS RD
Practice Address - Street 2:STE. 102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8723
Practice Address - Country:US
Practice Address - Phone:737-226-6700
Practice Address - Fax:737-226-6777
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX710008364SA2200X
TXAP115325364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187647604Medicaid
TXQ77749Medicare UPIN
TX8J3485Medicare PIN
TX330379YKYCMedicare PIN