Provider Demographics
NPI:1932413341
Name:PFEIFER, HOLLI B (CNP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLI
Middle Name:B
Last Name:PFEIFER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:HOLLI
Other - Middle Name:B
Other - Last Name:UJVARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5400 FRANTZ RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4144
Mailing Address - Country:US
Mailing Address - Phone:614-544-6366
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:725 N SANDUSKY AVE STE 1
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-1463
Practice Address - Country:US
Practice Address - Phone:419-562-7557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 11630-NP363LA2200X
OHAPRN.CNP.11630363LF0000X
OHCOA.11630-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP01643468OtherRRM
OH3142450Medicaid
OH3142450Medicaid