NATHANIEL CLAY HOLLANDSWORTH (NPI# 1457994394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457994394 |
| Entity Type | Individual |
| Full Name | NATHANIEL CLAY HOLLANDSWORTH |
| Credential | IDMT |
| Practice Address |
517 Harrison Dr Hurlburt Field FL 32544-1100 |
| Practice Telephone | 8506867411 |
| Mailing Telephone | 8506867411 |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2019-10-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| Street Address |
517 HARRISON DR |
| City | HURLBURT FIELD |
| State | FL |
| Zip Code | 32544-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629527270 | Jessica L Cardin | Dietitian, Registered | 1 Hume Drive, Hurlburt Field, FL 32544 | 2016-09-23 |
| 1366794828 | Tatiana Margarita Soria | Psychologist | Hurlburt Field, Hurlburt Field, FL 32544 | 2012-10-09 |
| 1962761312 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Building 91012, Independence Drive, Hurlbert Afb, FL 32544 | 2012-05-04 |
| 1285968271 | Daniel Milmo | Family Medicine | 113 Leimanis Ave, Hurlburt Field, FL 32544 | 2009-09-24 |
| 1962650341 | Christine Michele Zastrow | Psychologist | 100 Servais Way, Bldg 90531, Hurlburt Field, FL 32544 | 2008-08-28 |
| 1831248079 | Scott David Wright | Dentist | 113 Lielmanis Ave Bldg 91020, Hurlburt Field, FL 32544 | 2007-01-09 |
| 1437183209 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | Building 91012, Independence, Hurlburg Afb, FL 32544 | 2006-07-10 |
| 1053348375 | Kevin Robert Fischer | Physician Assistant | 113 Liemanis Ave, 16th Mdg, Hurlburt Field, FL 32544 | 2006-06-26 |
| 1114358488 | Denna Lantz | Social Worker | 113 Lielmanis Ave, Hurlburt Field, FL 32544 | 2013-12-11 |
| 1023444171 | Malloree Jne Smith | Psychologist | 225 Bennett Ave, 1st Special Operations Support Squadron, Hurlburt Field, FL 32544 | 2013-09-20 |
| Find all providers in zip 32544 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790911378 | Edward H Crowe | Military Health Care Provider | 100 Bartley St, Hq Afsoc/sgx, Hurlburt Field, FL 32544-5328 | 2009-06-09 |
| 1134353303 | Joseph Damian Jr. | Military Health Care Provider | 225 Bennett Ave, Hurlburt Field, FL 32544-5707 | 2009-05-04 |
| 1033353529 | Reth El | Military Health Care Provider | 113 Howie Walters Rd, Hurlburt Field, FL 32544-5668 | 2009-04-28 |
| 1497374011 | Austin Watson | Military Health Care Provider | 113 Lielmanis Ave, Hurlburt Field, FL 32544-5613 | 2020-04-14 |
| 1245865120 | Zachary E Lavoy | Military Health Care Provider | 113 Lielmanis Ave, Hurlburt Field, FL 32544-5613 | 2020-03-11 |
| 1235779034 | Jonathan James Sparks | Military Health Care Provider | 113 Lielmanis Ave, Hurlburt Field, FL 32544-5613 | 2020-01-09 |
| 1619439700 | Joshua Patterson | Military Health Care Provider | 113 Lielmanis Ave, Hurlburt Field, FL 32544-5613 | 2019-04-05 |
| 1992276125 | Patrick Ohara | Military Health Care Provider | 113 Lielmanis Ave, Hurlburt Field, FL 32544-5613 | 2018-12-16 |
| 1538699418 | Erik M Waldrip | Military Health Care Provider | 113 Lielmanis Ave, Hurlburt Field, FL 32544-5613 | 2017-06-14 |
| 1982137527 | Brendon Baez | Military Health Care Provider | 113 Lielmanis Ave, Hurlburt Field, FL 32544-5613 | 2017-04-11 |
| Find all providers in HURLBURT FIELD | ||||
| City | HURLBURT FIELD |
| Zip Code | 32544 |
Please comment or provide details below to improve the information on NATHANIEL CLAY HOLLANDSWORTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.