Provider Demographics
NPI:1093393704
Name:HOLTKAMP, SHARON MARY (RN)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MARY
Last Name:HOLTKAMP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 LAMBERTON RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3553
Mailing Address - Country:US
Mailing Address - Phone:216-965-3545
Mailing Address - Fax:
Practice Address - Street 1:10090 CHESTER AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1600
Practice Address - Country:US
Practice Address - Phone:216-721-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH164555163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care