MEDICARE: MISS HOLLY S. MESSINA CRNP

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	363LF0000X	Family Nurse Practitioner	APRN.CNP.12305	OH
2	363LF0000X	Family Nurse Practitioner	SP010246	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861633844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS HOLLY S. MESSINA CRNP

Provider Business Mailing Address
First Line	:	5533 MAHONING AVE FL 2
Second Line	:
City	:	AUSTINTOWN
State	:	OH
Zip	:	44515-2366
Country	:	US
Telephone Number	:	330-793-2701
Fax Number	:	330-793-8688

Provider Business Practice Location Address
First Line	:	5533 MAHONING AVE FL 2
Second Line	:
City	:	AUSTINTOWN
State	:	OH
Zip	:	44515-2366
Country	:	US
Telephone Number	:	330-793-2701
Fax Number	:	330-793-8688

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

Provider Enumeration Date	:	03/20/2009
Last Update Date	:	05/12/2021

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