Provider Demographics
NPI:1295793297
Name:HOLMQUIST, MARTHA MARY (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:MARY
Last Name:HOLMQUIST
Suffix:
Gender:
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:56334-0265
Mailing Address - Country:US
Mailing Address - Phone:320-760-6925
Mailing Address - Fax:
Practice Address - Street 1:20350 COUNTY ROAD 39
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:MN
Practice Address - Zip Code:56334-4004
Practice Address - Country:US
Practice Address - Phone:320-760-6925
Practice Address - Fax:320-239-2623
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8946363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health