Provider Demographics
NPI:1053690354
Name:HOLTON, CHRISTINE LYNNETTE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LYNNETTE
Last Name:HOLTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:LYNNETTE
Other - Last Name:VALITSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1415 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-3453
Mailing Address - Country:US
Mailing Address - Phone:440-536-4952
Mailing Address - Fax:
Practice Address - Street 1:1415 W 10TH ST
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-3453
Practice Address - Country:US
Practice Address - Phone:440-536-4952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN111834-MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse