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NPI Code Detail

MEDICARE: MS. SHONDA DENISE HOLTON

MEDICARE:  MS. SHONDA DENISE HOLTON
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
1164X00000XLicensed Vocational NursePN125334OH

General Provider Information

NPI Number : 1659510451
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHONDA DENISE HOLTON
Provider Business Mailing Address
First Line : 3681 SILSBY RD
Second Line :
City : UNIVERSITY HEIGHTS
State : OH
Zip : 44118-3657
Country : US
Telephone Number : 216-320-9978
Fax Number :
Provider Business Practice Location Address
First Line : 3681 SILSBY RD
Second Line :
City : UNIVERSITY HEIGHTS
State : OH
Zip : 44118-3657
Country : US
Telephone Number : 216-320-9978
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2009
Last Update Date : 02/18/2009

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Directions to “ MS. SHONDA DENISE HOLTON ” Practice Location

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