Provider Demographics
NPI:1215298914
Name:HOLWEGNER, PAMELA K (FNP-C)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:K
Last Name:HOLWEGNER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:K
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5010
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58702-5010
Mailing Address - Country:US
Mailing Address - Phone:701-857-5650
Mailing Address - Fax:701-857-5031
Practice Address - Street 1:831 S BROADWAY
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4636
Practice Address - Country:US
Practice Address - Phone:701-857-3535
Practice Address - Fax:701-857-5171
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR25646363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner