Provider Demographics
NPI:1225154958
Name:KOLLHOFF, AMY MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MICHELLE
Last Name:KOLLHOFF
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 1:1114 BUNKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-7611
Mailing Address - Country:US
Mailing Address - Phone:440-812-6702
Mailing Address - Fax:
Practice Address - Street 1:1114 BUNKER HILL RD
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-7611
Practice Address - Country:US
Practice Address - Phone:440-812-6702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH272742163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health