Provider Demographics
NPI:1346453230
Name:HOLLENBACH, BILLIE SUE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:BILLIE
Middle Name:SUE
Last Name:HOLLENBACH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 NORTH HANNA STREET
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-2243
Mailing Address - Country:US
Mailing Address - Phone:570-295-2686
Mailing Address - Fax:
Practice Address - Street 1:25 NORTH HANNA STREET
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-2243
Practice Address - Country:US
Practice Address - Phone:570-295-2686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN263041164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse