Provider Demographics
NPI:1700579539
Name:HOLTZAPFEL, CONNIE ANN
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:ANN
Last Name:HOLTZAPFEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 CAMP ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN FURNACE
Mailing Address - State:OH
Mailing Address - Zip Code:45629-8999
Mailing Address - Country:US
Mailing Address - Phone:740-464-7768
Mailing Address - Fax:
Practice Address - Street 1:11954 STATE ROUTE 139 UNIT C
Practice Address - Street 2:
Practice Address - City:MINFORD
Practice Address - State:OH
Practice Address - Zip Code:45653-8003
Practice Address - Country:US
Practice Address - Phone:740-820-3816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide