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General NPI Number Information
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NPI Number | 1144270505
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Entity Type | Individual
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Provider Name | BEVERLY ANN HOLBERT N.P.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 325 W WALNUT ST
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City | LEBANON
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State | KY
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Zip | 40033-1377
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Country | US
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Telephone | 270-699-9500
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Fax | 270-699-9550
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Provider Business Mailing Address
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Address Line | 390 NEWTON VALLEY LN
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City | NEW HAVEN
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State | KY
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Zip | 40051-6155
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Country | US
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Telephone | 502-549-3309
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 3313P
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License Number State | KY
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