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NPI Code Detail

MEDICARE: PAMELA JANE HOLT CRNP

MEDICARE: PAMELA JANE HOLT CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LX0001XObstetrics & Gynecology Nurse Practitioner535333TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972584951
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA JANE HOLT CRNP
Provider Business Mailing Address
First Line : 609 MCFARLAND ST
Second Line :
City : MORRISTOWN
State : TN
Zip : 37814-3976
Country : US
Telephone Number : 423-492-8700
Fax Number : 423-492-8701
Provider Business Practice Location Address
First Line : 609 MCFARLAND ST
Second Line :
City : MORRISTOWN
State : TN
Zip : 37814-3976
Country : US
Telephone Number : 423-492-8700
Fax Number : 423-492-8701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 04/28/2015

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