Provider Demographics
NPI:1710211800
Name:HOLZER-VOSS, TONYA M (CRNA)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:M
Last Name:HOLZER-VOSS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1720 UNIVERSITY DR S RT 1707
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6104
Mailing Address - Country:US
Mailing Address - Phone:701-234-1728
Mailing Address - Fax:701-234-1681
Practice Address - Street 1:1720 UNIVERSITY DR S RT 1707
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6104
Practice Address - Country:US
Practice Address - Phone:701-234-1728
Practice Address - Fax:701-234-1681
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR28183367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1710211800Medicaid