Provider Demographics
NPI:1023517125
Name:LABERTEW, HOLLY E (ARNP)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:E
Last Name:LABERTEW
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E SALEM AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-2830
Mailing Address - Country:US
Mailing Address - Phone:515-862-1089
Mailing Address - Fax:
Practice Address - Street 1:900 E SALEM AVE
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-2830
Practice Address - Country:US
Practice Address - Phone:515-865-1089
Practice Address - Fax:515-865-1089
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA115236363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily