Provider Demographics
NPI:1952564742
Name:HOLZINGER, JACQUILYNE DARLENE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JACQUILYNE
Middle Name:DARLENE
Last Name:HOLZINGER
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:PO BOX 2569
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98213-0569
Mailing Address - Country:US
Mailing Address - Phone:425-375-5888
Mailing Address - Fax:425-353-3552
Practice Address - Street 1:7003 EVERGREEN WAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-5153
Practice Address - Country:US
Practice Address - Phone:425-374-5888
Practice Address - Fax:425-353-3552
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00094350163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse