Provider Demographics
NPI:1104601343
Name:HOLDEN, CHARONDA (RN)
Entity type:Individual
Prefix:
First Name:CHARONDA
Middle Name:
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5815 DODSWORTH LN
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2443
Mailing Address - Country:US
Mailing Address - Phone:216-357-9559
Mailing Address - Fax:
Practice Address - Street 1:5815 DODSWORTH LN
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2443
Practice Address - Country:US
Practice Address - Phone:216-357-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH517717163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice