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General NPI Number Information
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NPI Number | 1326251042
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Entity Type | Organization
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Legal Business Name | TRACY LYN HOLLAND LPN
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 408 SAINT JOSEPH ST.
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City | FREMONT
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State | OH
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Zip | 43420-4630
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Country | US
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Telephone | 419-334-8466
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Fax |
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Provider Business Mailing Address
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Address Line | 408 SAINT JOSEPH ST
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City | FREMONT
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State | OH
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Zip | 43420-4630
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MS. TRACY LYN HOLLAND
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Credential |
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Telephone | 419-334-8466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PN118417
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | PN118417
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | PN118417
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License Number State | OH
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