Provider Demographics
NPI:1013691484
Name:HOLMQUIST, JOEL ROBERT (OD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ROBERT
Last Name:HOLMQUIST
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16861 BROWNE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-3202
Mailing Address - Country:US
Mailing Address - Phone:308-214-1215
Mailing Address - Fax:
Practice Address - Street 1:3351 E 24TH ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2446
Practice Address - Country:US
Practice Address - Phone:402-704-6964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1615152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist