MEDICARE: MRS. KRISTY LYNN HOLSINGER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2634537	OTHER	OH	IP NUMBER

General Provider Information

NPI Number	:	1427263342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTY LYNN HOLSINGER

Provider Business Mailing Address
First Line	:	357 OPAL DR
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907
Country	:	US
Telephone Number	:	419-961-7882
Fax Number	:

Provider Business Practice Location Address
First Line	:	780 W STRAUB RD
Second Line	:	APT 1-B
City	:	MANSFIELD
State	:	OH
Zip	:	44904
Country	:	US
Telephone Number	:	419-756-4045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	07/08/2007

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