Provider Demographics
NPI:1457192627
Name:HOLTERMAN, JANET ROSE (RN)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:ROSE
Last Name:HOLTERMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N78W22956 N COLDWATER CIR
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-1576
Mailing Address - Country:US
Mailing Address - Phone:262-408-1036
Mailing Address - Fax:
Practice Address - Street 1:N78W22956 N COLDWATER CIR
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-1576
Practice Address - Country:US
Practice Address - Phone:262-408-1036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI93159163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health