Provider Demographics
NPI:1881602712
Name:HOLZMEISTER, RANDI K (LPN)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:K
Last Name:HOLZMEISTER
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 1:212 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:KS
Mailing Address - Zip Code:67748-1220
Mailing Address - Country:US
Mailing Address - Phone:785-672-3261
Mailing Address - Fax:785-672-8194
Practice Address - Street 1:212 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:KS
Practice Address - Zip Code:67748-1220
Practice Address - Country:US
Practice Address - Phone:785-672-3261
Practice Address - Fax:785-672-8194
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2327040011164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse