Provider Demographics
NPI:1457832503
Name:OSTROWSKI, HOLLY LEANN (RN)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:LEANN
Last Name:OSTROWSKI
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 1:1116 N 57TH AVE W
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55807-1364
Mailing Address - Country:US
Mailing Address - Phone:218-226-8143
Mailing Address - Fax:
Practice Address - Street 1:1116 N 57TH AVE W
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55807-1364
Practice Address - Country:US
Practice Address - Phone:218-226-8143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI227716-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health