Provider Demographics
NPI:1821843103
Name:HOLLOBAUGH, NATALIE LYN (NP)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:LYN
Last Name:HOLLOBAUGH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13211 CHERWIN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1007
Mailing Address - Country:US
Mailing Address - Phone:443-869-0830
Mailing Address - Fax:
Practice Address - Street 1:11560 CROSSROADS CIR STE 102
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-2885
Practice Address - Country:US
Practice Address - Phone:410-508-0722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-20
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR170888363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health