Holly Macdonald

Individual provider Active NPI Licensed Practical Nurse · Paulding, OH

NPI 1104228923 · NPPES record last updated Sep 24, 2014

Key facts

NPI
1104228923
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
133054 (OH)
Practice address
13153 Road 126
Paulding, OH 45879-9444
Phone
(419) 769-0537
NPI assigned
Sep 24, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
133054OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 133054 OH Yes

Addresses

Primary practice location

13153 Road 126
Paulding, OH 45879-9444

Mailing address

13153 Rd 126
Paulding, OH 45879
Phone (419) 769-0537

Other providers in Paulding, OH

All providers in Paulding, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.