Provider Demographics
NPI:1376596361
Name:VON HOLLEN, NAOMI JEAN (ARNP)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:JEAN
Last Name:VON HOLLEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:JEAN
Other - Last Name:SYNSTEGARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 LANGWORTHY ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-7365
Mailing Address - Country:US
Mailing Address - Phone:563-584-3330
Mailing Address - Fax:563-584-4422
Practice Address - Street 1:1000 LANGWORTHY ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7365
Practice Address - Country:US
Practice Address - Phone:563-584-3330
Practice Address - Fax:563-584-4422
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60396767363L00000X
IAA157454363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0477760Medicaid
S26297Medicare UPIN
IA0477760Medicaid