Healthcare Provider Details

I. General information

NPI: 1992802698
Provider Name (Legal Business Name): CATHY JO HOLLIN R.N
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 03/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14055 NEW HARMONY SALEM RD
MOUNT ORAB OH
45154-9008
US

IV. Provider business mailing address

14055 NEW HARMONY SALEM RD
MOUNT ORAB OH
45154-9008
US

V. Phone/Fax

Practice location:
  • Phone: 513-532-1148
  • Fax: 513-532-1148
Mailing address:
  • Phone: 513-532-1148
  • Fax: 513-532-1148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN. 249879
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: