Provider Demographics
NPI:1063027399
Name:HOLDERBY, JOAN KAY
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:KAY
Last Name:HOLDERBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9456 MILL DAM RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:OH
Mailing Address - Zip Code:43025-9706
Mailing Address - Country:US
Mailing Address - Phone:740-928-7701
Mailing Address - Fax:
Practice Address - Street 1:9456 MILL DAM RD
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:OH
Practice Address - Zip Code:43025-9706
Practice Address - Country:US
Practice Address - Phone:740-928-7701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker