Provider Demographics
NPI:1548088602
Name:HOLLOWAY, SASSHAY (LPN)
Entity type:Individual
Prefix:
First Name:SASSHAY
Middle Name:
Last Name:HOLLOWAY
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 1:833 GLENN ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-3713
Mailing Address - Country:US
Mailing Address - Phone:330-687-9066
Mailing Address - Fax:
Practice Address - Street 1:833 GLENN ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-3713
Practice Address - Country:US
Practice Address - Phone:330-687-9066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.184754.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse