Provider Demographics
NPI:1720287105
Name:HOLZHEIMER, COURTNEY B (CNP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:B
Last Name:HOLZHEIMER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 SPRINGSIDE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4548
Mailing Address - Country:US
Mailing Address - Phone:234-466-4083
Mailing Address - Fax:866-211-7728
Practice Address - Street 1:6511 FLEET AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-3416
Practice Address - Country:US
Practice Address - Phone:216-341-9227
Practice Address - Fax:216-341-3208
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-241434363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNP24331Medicare PIN