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General NPI Number Information
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NPI Number | 1366271306
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Entity Type | Individual
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Provider Name | CYLEIGH MARIN HOLT RN
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Gender | Female
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Dates
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Enumeration Date | 07/29/2024
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 330 PAGEANT LN
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City | CLARKSVILLE
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State | TN
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Zip | 37040-3854
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Country | US
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Telephone | 931-648-5747
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 HENRY PLACE BLVD UNIT 104
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City | CLARKSVILLE
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State | TN
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Zip | 37042-1998
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Country | US
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Telephone | 615-919-3684
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 272283
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License Number State | TN
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