MEDICARE: COURTNEY B HOLZHEIMER CNP

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	363LP0200X	Pediatric Nurse Practitioner	RN-241434	OH

General Provider Information

NPI Number	:	1720287105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY B HOLZHEIMER CNP

Provider Business Mailing Address
First Line	:	275 SPRINGSIDE DR
Second Line	:	SUITE 100
City	:	AKRON
State	:	OH
Zip	:	44333-4548
Country	:	US
Telephone Number	:	234-466-4083
Fax Number	:	866-211-7728

Provider Business Practice Location Address
First Line	:	6511 FLEET AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-3416
Country	:	US
Telephone Number	:	216-341-9227
Fax Number	:	216-341-3208

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

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	12/13/2007

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