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NPI Code Detail

MEDICARE: MRS. HOLLY L INMAN CRNP

MEDICARE: MRS. HOLLY L INMAN CRNP
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
1363LF0000XFamily Nurse Practitioner160406OH
2363LF0000XFamily Nurse PractitionerAPRN.CNP.08574OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609993013
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HOLLY L INMAN CRNP
Provider Business Mailing Address
First Line : 125 CANTON RD NW STE A
Second Line :
City : CARROLLTON
State : OH
Zip : 44615-1009
Country : US
Telephone Number : 330-627-8163
Fax Number : 330-627-0197
Provider Business Practice Location Address
First Line : 125 CANTON RD NW STE A
Second Line :
City : CARROLLTON
State : OH
Zip : 44615-1009
Country : US
Telephone Number : 330-627-8163
Fax Number : 330-627-0197
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2007
Last Update Date : 09/21/2021

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