Healthcare Provider Details

I. General information

NPI: 1073331153
Provider Name (Legal Business Name): ELIZABETH HOHLBEIN RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2024
Last Update Date: 09/28/2024
Certification Date: 09/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 E MAIN ST
ANNA OH
45302-9805
US

IV. Provider business mailing address

10744 THOMPSON SCHIFF RD
SIDNEY OH
45365-8462
US

V. Phone/Fax

Practice location:
  • Phone: 937-638-4028
  • Fax:
Mailing address:
  • Phone: 937-638-4028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN.433527
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: