Provider Demographics
NPI:1215683164
Name:PRZYOJSKI, HOLLY DANIELLE
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:DANIELLE
Last Name:PRZYOJSKI
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 1:3608 S CHAMPION AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-5145
Mailing Address - Country:US
Mailing Address - Phone:614-571-5142
Mailing Address - Fax:
Practice Address - Street 1:3608 S CHAMPION AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-5145
Practice Address - Country:US
Practice Address - Phone:614-571-5142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11064098200Medicaid