Provider Demographics
NPI:1457328122
Name:TALKINGTON, HOLLY L (CRNA)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:L
Last Name:TALKINGTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6465 NORTHERN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68152-1041
Mailing Address - Country:US
Mailing Address - Phone:402-572-6500
Mailing Address - Fax:402-572-6501
Practice Address - Street 1:16901 LAKESIDE HILLS CT
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2318
Practice Address - Country:US
Practice Address - Phone:402-572-6500
Practice Address - Fax:402-572-6501
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE100782367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025104200Medicaid
NE47061979815Medicaid
NE10025104200Medicaid
NEP00731878Medicare PIN
NE47061979815Medicaid
NE275108Medicare ID - Type Unspecified