Healthcare Provider Details

I. General information

NPI: 1881090009
Provider Name (Legal Business Name): MEGAN ELIZABETH HOLIAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2014
Last Update Date: 11/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 WINCHESTER AVE
LAKEWOOD OH
44107-5032
US

IV. Provider business mailing address

1426 RIDGEWOOD AVE
LAKEWOOD OH
44107-5015
US

V. Phone/Fax

Practice location:
  • Phone: 216-507-0066
  • Fax:
Mailing address:
  • Phone: 216-507-0066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number380173
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number380173
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: