Individual
SHANNON L HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1115 WOODLAND DR, ELIZABETHTOWN, KY 42701-2749
(270) 769-5963
(270) 769-9051
Mailing address
1115 WOODLAND DR, ELIZABETHTOWN, KY 42701-2749
(270) 769-5963
(270) 769-9051
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
37416
KY
207VX0000X
Obstetrics Physician
37416
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64085442
—
KY
Enumeration date
06/16/2006
Last updated
11/09/2009
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