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Individual
ANGELINA DAWN HOLT
Active
Individual
ANGELINA DAWN HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
006317
GA
363A00000X
Physician Assistant
0110005126
VA
363A00000X
Physician Assistant
4254
CT
363A00000X
Physician Assistant
PA12050
TX
363A00000X
Physician Assistant
Primary
PA9116010
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003118596A
—
GA
01
—
01477593
AMERIGROUP
—
05
—
1319PA
—
SC
01
—
643345
WELLCARE
GA
01
—
P00994128
RAILROAD MEDICARE
GA
Enumeration date
11/18/2011
Last updated
11/21/2022
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