Joanna Lynn Holbrook, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

075320 Issued in OH

Practice address

475 Lexington Ave
Mansfield, OH 44907-1501

Phone

(419) 419-5705

Fax

(419) 775-1254

NPI assigned

Apr 27, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Joanna Lynn Tanner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ohio Treatment Center, LLC

  • Methadone Clinic
  • Massillon, OH
  • NPI 1295233054
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1710569926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071501",
            "telephone_number": "419-419-5705",
            "fax_number": "419-775-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071501",
            "telephone_number": "419-419-5705",
            "fax_number": "419-775-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "JOANNA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "075320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "TANNER",
            "middle_name": "LYNN",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David H Hofstetter, P.T.
• Mark Hogsed, PT, DPT
• Susan Hogsette, PT
• Tabitha L Hoke-Mujihad, LSW
• Haylee A. Holbrook
• Marie L Holbrook, CMS
• Christina Hollabaugh, MA, F-AAA
• Stephanie Holley
• Hannah Marie Holliday
• Carrie Ann Hollister, RN

• Licensed Practical Nurse in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.