MEDICARE: AMY HOLLENKAMP RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	LD.08543	OH

General Provider Information

NPI Number	:	1487530754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY HOLLENKAMP RD

Provider Business Mailing Address
First Line	:	2315 HEATHER HILL BLVD N
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45244-2666
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1785 STONEHOUSE LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45255-2431
Country	:	US
Telephone Number	:	513-460-8262
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	08/13/2025

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