Lydia Jean Eva Holley, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN85830 Issued in TN

Practice address

1032 McCallie Ave
Chattanooga, TN 37403-2800

Phone

(423) 266-4588

Fax

(865) 342-0103

NPI assigned

Jun 26, 2017

Last updated

Jun 26, 2017By the provider in NPPES

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

• Lydia Jean Eva Graham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1932629458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 W ANDREW JOHNSON HWY DEPT 100",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378778605",
            "telephone_number": "800-355-3565",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032800",
            "telephone_number": "423-266-4588",
            "fax_number": "865-342-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "LYDIA",
        "middle_name": "JEAN EVA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "LPN85830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYDIA",
            "last_name": "GRAHAM",
            "middle_name": "JEAN EVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Harold Randolph Holder, DDS
• Jada Aliyas Holder
• Derek Weldon Holland, M.D.
• Nancy D Holland, LPE
• Jessica Holleman, PHARMD
• Sara Holley
• Paul Michael Holliday, DDS
• Matthew Michael Hollie, MD
• Michael C Hollie, M.D.
• Shalmai Drake Hollingshead, CPM

• Licensed Practical Nurse in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Licensed Practical Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; 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.