Provider Demographics
NPI:1922182195
Name:HOLSOPPLE, JOANN MARIE
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:MARIE
Last Name:HOLSOPPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17886 DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-7045
Mailing Address - Country:US
Mailing Address - Phone:440-878-9343
Mailing Address - Fax:440-878-9343
Practice Address - Street 1:6905 RIDGE RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5648
Practice Address - Country:US
Practice Address - Phone:440-884-5204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2365588OtherPERSONAL CARE AIDE