Jacquelyn H Holloway, REGISTERED NURSE

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

890576 Issued in TX

Practice address

801 Forest Ridge Dr Ste 104
Bedford, TX 76022-7240

Phone

(405) 596-2830

NPI assigned

Aug 18, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1376155754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1744",
            "city": "BEDRORD",
            "state": "TX",
            "postal_code": "76022",
            "telephone_number": "405-596-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 FOREST RIDGE DR STE 104",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760227240",
            "telephone_number": "405-596-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "JACQUELYN",
        "middle_name": "H",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "890576",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "TX",
            "license": "890576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Hilton
• Lam Hoang, DDS
• Phillip Hobbs
• Karen Lynn Hoffman, ANP
• Jana Hollingsworth
• Decorla Holmes, LICENSED NURSE
• Heather Marie Holtrop, PA-C
• Home Based Care and Counseling Programe Inc.
• Kathy Hong
• Katrina Maria Hooker

• Adult Psychiatric/Mental Health Registered Nurse in Bedford, TX
• Providers in Bedford, TX by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.