Provider Demographics
NPI:1518504919
Name:ATKINS HOLSHUE, ERICA (QMHS CMS)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:ATKINS HOLSHUE
Suffix:
Gender:F
Credentials:QMHS CMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36466 STATE ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-9417
Mailing Address - Country:US
Mailing Address - Phone:234-736-8425
Mailing Address - Fax:
Practice Address - Street 1:36466 STATE ROUTE 30
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-9417
Practice Address - Country:US
Practice Address - Phone:234-736-8425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-04
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174400000XOther Service ProvidersSpecialist