Provider Demographics
NPI:1356931596
Name:HOLLENBACK, RUTH KATHERINE (BS)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:KATHERINE
Last Name:HOLLENBACK
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 WYNKOOP ST APT 624
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1172
Mailing Address - Country:US
Mailing Address - Phone:303-601-9562
Mailing Address - Fax:
Practice Address - Street 1:1648 GAYLORD ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1239
Practice Address - Country:US
Practice Address - Phone:303-336-1631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator