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Contact Information

JACK HOLLAND, CRNA
HEBER VALLEY HOSPITAL
1485 US-40
HEBER CITY, UT84032
 Phone: 435-654-2500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for JACK HOLLAND · (Male)

NPI Number 1699755231
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 01/19/2006
Last updated 10/26/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 053081
  • NC License # 161328
  • NV License # 821399
  • UT License # 9809402-4406
  • NC Medicaid 8051521
Hospital affiliation(s)
  • NORTHEASTERN NEVADA REGIONAL HOSPITAL - (Acute Care)
    2001 ERRECART BLVD
    ELKO, NV 89801
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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