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General NPI Number Information
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NPI Number | 1679934590
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Entity Type | Individual
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Provider Name | MELISSA LYNN HOLTZ CNP
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Gender | Female
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Dates
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Enumeration Date | 03/20/2016
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Last Update Date | 07/23/2020
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Provider Practice Location Address
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Address Line | 5172 LEAVITT RD
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City | LORAIN
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State | OH
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Zip | 44053-2384
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Country | US
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Telephone | 440-282-7420
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Fax | 440-282-9855
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Provider Business Mailing Address
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Address Line | 596 LAKE FOREST DR
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City | BAY VILLAGE
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State | OH
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Zip | 44140-2513
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Country | US
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Telephone | 440-320-3001
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN.341647
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License Number State | OH
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