Healthcare Provider Details

I. General information

NPI: 1316254931
Provider Name (Legal Business Name): CINDY L HOLT RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CINDY MILLER RN, BSN

II. Dates (important events)

Enumeration Date: 09/02/2010
Last Update Date: 09/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 W COURT ST SUITE 8
PASCO WA
99301-4178
US

IV. Provider business mailing address

PO BOX 904
RICHLAND WA
99352-0904
US

V. Phone/Fax

Practice location:
  • Phone: 509-545-6506
  • Fax:
Mailing address:
  • Phone: 509-554-3641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number69870
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: