Provider Demographics
NPI:1316283344
Name:LAMBDIN, HOLLYANN (ACNP)
Entity type:Individual
Prefix:
First Name:HOLLYANN
Middle Name:
Last Name:LAMBDIN
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:HOLLYANN
Other - Middle Name:
Other - Last Name:TUHOLSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP
Mailing Address - Street 1:1122 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526-3819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1122 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-3819
Practice Address - Country:US
Practice Address - Phone:574-533-0560
Practice Address - Fax:574-533-1716
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004410A363LF0000X, 363L00000X, 363LF0000X, 364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201205140Medicaid
IN201205140Medicaid
ININ1933016Medicare PIN