Holt, Mary R.

Holt, Mary R. is an individual health care provider with primary practice located at 935 Baxter St Se , Grand Rapids MI 49506-2500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Holt, Mary R. can be contacted via phone (616) 456-5310.

Contact Information

Primary practice address
935 Baxter St Se Grand Rapids MI 49506-2500
Fax: (616) 456-8640
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 4704109296 Michigan

Profile Details

NPI number 1073772984
LBN Legal business name Holt, Mary R.
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2008
Last updated Jun 5th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073772984 NPPES
Michigan MEDICAID 2742857

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