Healthcare Provider Details

I. General information

NPI: 1013212893
Provider Name (Legal Business Name): NANCY ESTHER HOLDER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2011
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4145 SUN N LAKE BLVD STE A
SEBRING FL
33872-2131
US

IV. Provider business mailing address

4145 SUN N LAKE BLVD STE A
SEBRING FL
33872-2131
US

V. Phone/Fax

Practice location:
  • Phone: 201-640-0696
  • Fax:
Mailing address:
  • Phone: 863-546-0030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number17286
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number28877
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number17286
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number17286
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: