Healthcare Provider Details

I. General information

NPI: 1851718399
Provider Name (Legal Business Name): STEVEN ALLEN HOLMAN AGNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2014
Last Update Date: 04/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 W CARO RD
CARO MI
48723-9686
US

IV. Provider business mailing address

9904 ALBA HWY
ELMIRA MI
49730-9299
US

V. Phone/Fax

Practice location:
  • Phone: 989-672-2100
  • Fax:
Mailing address:
  • Phone: 231-584-2091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4704266143
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704266143
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: