Provider Demographics
NPI:1669926069
Name:HOLWEGER, KRISTINA (LPN)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:HOLWEGER
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 1:16 FARM AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-2721
Mailing Address - Country:US
Mailing Address - Phone:937-743-8640
Mailing Address - Fax:937-743-8642
Practice Address - Street 1:16 FARM AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-2721
Practice Address - Country:US
Practice Address - Phone:937-743-8640
Practice Address - Fax:937-743-8642
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN155560-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse