Provider Demographics
NPI:1508553983
Name:HOLLIDAY, KLAUDIJA
Entity Type:Individual
Prefix:
First Name:KLAUDIJA
Middle Name:
Last Name:HOLLIDAY
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 1:421 OAKLAND HILLS LOOP
Mailing Address - Street 2:
Mailing Address - City:COMMERCIAL POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43116-0016
Mailing Address - Country:US
Mailing Address - Phone:424-347-4115
Mailing Address - Fax:
Practice Address - Street 1:421 OAKLAND HILLS LOOP
Practice Address - Street 2:
Practice Address - City:COMMERCIAL POINT
Practice Address - State:OH
Practice Address - Zip Code:43116-0016
Practice Address - Country:US
Practice Address - Phone:424-347-4115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.439458163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse