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General NPI Number Information
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NPI Number | 1598755571
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Entity Type | Individual
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Provider Name | KATHY HOLT FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/21/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 30999 COUNTY RD 15
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City | FORT LYON
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State | CO
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Zip | 81038
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Country | US
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Telephone | 719-456-3550
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Fax |
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Provider Business Mailing Address
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Address Line | 501 N 8TH ST
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City | ROCKY FORD
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State | CO
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Zip | 81067-1215
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Country | US
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Telephone | 719-254-6046
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 162801
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License Number State | CO
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