Active NPI
Amy Nicole Holub, PHARM.D.
- Pharmacist
- Appleton, WI
National Provider Identifier
1609152552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15557-40
- Practice address
- 3330 E Calumet St
Appleton, WI 54915-4127 - Phone
- (920) 733-3016
- Fax
- (920) 733-3218
- NPI assigned
- Oct 24, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15557-40 | WI | Primary |
Addresses
Primary practice location
3330 E Calumet St
Appleton, WI 54915-4127
Mailing address
3330 E Calumet St
Appleton, WI 54915-4127
Phone (920) 733-3016
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15557-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319414400000",
"number": "1609152552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3330 E CALUMET ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549154127",
"telephone_number": "920-733-3016",
"fax_number": "920-733-3218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3330 E CALUMET ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549154127",
"telephone_number": "920-733-3016",
"fax_number": "920-733-3218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLUB",
"first_name": "AMY",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-24",
"last_updated": "2011-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "15557-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.