Healthcare Provider Details

I. General information

NPI: 1205178738
Provider Name (Legal Business Name): WILLIAM E HOLDER FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 E MCKELLIPS RD STE 103
MESA AZ
85203-2855
US

IV. Provider business mailing address

4505 E CHANDLER BLVD STE 200
PHOENIX AZ
85048-7688
US

V. Phone/Fax

Practice location:
  • Phone: 480-961-2365
  • Fax: 480-961-2382
Mailing address:
  • Phone: 480-961-2365
  • Fax: 480-961-2382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP4885
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: