Basic Information
Provider Information
NPI: 1093737454
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLLOWAY
FirstName: MEI-HUEY
MiddleName: LIN
NamePrefix: MS.
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 110 PEACHTREE LANE
Address2: APT 2
City: YAKIMA
State: WA
PostalCode: 98908
CountryCode: US
TelephoneNumber: 5099662324
FaxNumber:  
Practice Location
Address1: 717 FRUITVALE BLVD
Address2:  
City: YAKIMA
State: WA
PostalCode: 989021465
CountryCode: US
TelephoneNumber: 5099660199
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/24/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP30006267WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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