Holly Rosemary Irwin, LMT
Individual provider Active NPI Massage Therapist · Haines, AK
NPI 1760938690 · NPPES record last updated Aug 31, 2016
Key facts
- NPI
- 1760938690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 104423 (AK)
- Practice address
- 251 Battle Rd
Haines, AK 99827-0915 - Phone
- (907) 314-3049
- NPI assigned
- Aug 31, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104423 | AK | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 104423 | AK | Yes |
Addresses
Primary practice location
251 Battle Rd
Haines, AK 99827-0915
Mailing address
PO Box 915
Haines, AK 99827-0915
Phone (907) 314-3049
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104423 | Other | AK | STATE OF ALASKA |
Other providers in Haines, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.