Healthcare Provider Details

I. General information

NPI: 1316283344
Provider Name (Legal Business Name): HOLLYANN LAMBDIN ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLLYANN TUHOLSKI ACNP

II. Dates (important events)

Enumeration Date: 12/19/2012
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 PROFESSIONAL DR
GOSHEN IN
46526-3819
US

IV. Provider business mailing address

1122 PROFESSIONAL DR
GOSHEN IN
46526-3819
US

V. Phone/Fax

Practice location:
  • Phone: 574-533-0560
  • Fax: 574-533-1716
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71004410A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71004410A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: