Provider Demographics
NPI:1255132031
Name:HOLLAND, AUNTINE' S (MA, NA)
Entity type:Individual
Prefix:
First Name:AUNTINE'
Middle Name:S
Last Name:HOLLAND
Suffix:
Gender:
Credentials:MA, NA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 IDA ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68112-3203
Mailing Address - Country:US
Mailing Address - Phone:402-598-3932
Mailing Address - Fax:
Practice Address - Street 1:2430 IDA ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68112-3203
Practice Address - Country:US
Practice Address - Phone:402-598-3932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE95493376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide