Provider Demographics
NPI:1245248756
Name:HOLLINGS, JENNIFER JONES (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JONES
Last Name:HOLLINGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1535 GULL RD STE 250
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1661
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1535 GULL RD STE 250
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1661
Practice Address - Country:US
Practice Address - Phone:269-226-5927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101248487207V00000X
MI4301079732207V00000X
IL036115301174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06115OtherMEDICARE GROUP PTAN
IL036115301Medicaid
IL1821211129OtherGROUP NPI
VAC06115OtherMEDICARE GROUP PTAN