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NPI Code Detail

MEDICARE: KATHRYN HOLLOWAY FNP

MEDICARE: KATHRYN HOLLOWAY FNP
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
1207Q00000XFamily Medicine PhysicianAPRN.CNP.022267OH
2363LF0000XFamily Nurse PractitionerAPRN.CNP.022267OH

General Provider Information

NPI Number : 1922506211
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN HOLLOWAY FNP
Provider Business Mailing Address
First Line : PO BOX 11167
Second Line :
City : FORT WAYNE
State : IN
Zip : 46856-1167
Country : US
Telephone Number : 574-546-1900
Fax Number :
Provider Business Practice Location Address
First Line : 4400 EASTON CMNS STE 125
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-6223
Country : US
Telephone Number : 574-546-1900
Fax Number : 574-546-1999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2018
Last Update Date : 08/05/2022

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