Provider Demographics
NPI:1952769648
Name:HOLLOWELL, LEELYN (AG-ACNP)
Entity Type:Individual
Prefix:
First Name:LEELYN
Middle Name:
Last Name:HOLLOWELL
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:LEELYN
Other - Middle Name:RUTH
Other - Last Name:ALTMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3350
Mailing Address - Fax:412-359-6494
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3350
Practice Address - Fax:412-359-6494
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026097363LA2100X
DCRN1024104363LA2100X, 363LA2100X
DC1024104163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse