Provider Demographics
NPI:1194771360
Name:FREEZE, HOLLIE LYNN (LPN)
Entity type:Individual
Prefix:
First Name:HOLLIE
Middle Name:LYNN
Last Name:FREEZE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WESTLINE DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1539
Mailing Address - Country:US
Mailing Address - Phone:513-312-0749
Mailing Address - Fax:
Practice Address - Street 1:102 WESTLINE DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1539
Practice Address - Country:US
Practice Address - Phone:513-312-0749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-100204164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse