Provider Demographics
NPI:1689476798
Name:HOLLOMAN, JENIFER LOUISE
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:LOUISE
Last Name:HOLLOMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 MAYFAIR RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02660-2803
Mailing Address - Country:US
Mailing Address - Phone:774-207-7520
Mailing Address - Fax:
Practice Address - Street 1:234 MAYFAIR RD
Practice Address - Street 2:
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-2803
Practice Address - Country:US
Practice Address - Phone:774-207-7520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty