Provider Demographics
NPI:1295988475
Name:WIEMAN EDWARDS, HOLLY (LPN)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:
Last Name:WIEMAN EDWARDS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:HOLLY
Other - Middle Name:ANN
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9235 RUM RUN
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1698
Mailing Address - Country:US
Mailing Address - Phone:419-306-4443
Mailing Address - Fax:
Practice Address - Street 1:9235 RUM RUN
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1698
Practice Address - Country:US
Practice Address - Phone:419-306-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN1119713140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric