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
Phone: (616) 456-5310
Fax: (616) 456-8640
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073772984 | NPPES |
| Michigan | MEDICAID | 2742857 |
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