Provider Demographics
NPI:1518368737
Name:ALLISON, HOLLY NICOLE (LPN)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:NICOLE
Last Name:ALLISON
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 1:306 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BALTIMORE
Mailing Address - State:OH
Mailing Address - Zip Code:45872-1305
Mailing Address - Country:US
Mailing Address - Phone:419-408-0918
Mailing Address - Fax:
Practice Address - Street 1:306 S 2ND ST
Practice Address - Street 2:
Practice Address - City:NORTH BALTIMORE
Practice Address - State:OH
Practice Address - Zip Code:45872-1305
Practice Address - Country:US
Practice Address - Phone:419-408-0918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 124775-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse