Provider Demographics
NPI:1033455084
Name:SPAULDING, HOLLY JEANNETTE (CNA)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:JEANNETTE
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MRS
Other - First Name:HOLLY
Other - Middle Name:JEANNETTE
Other - Last Name:SPAULDING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNA
Mailing Address - Street 1:257 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CARDINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43315-9721
Mailing Address - Country:US
Mailing Address - Phone:614-753-9027
Mailing Address - Fax:
Practice Address - Street 1:257 S 3RD ST
Practice Address - Street 2:
Practice Address - City:CARDINGTON
Practice Address - State:OH
Practice Address - Zip Code:43315-9721
Practice Address - Country:US
Practice Address - Phone:614-753-9027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH321744310101374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide