Individual
ALAN D HOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
44 N 1ST E, PRESTON, ID 83263-1326
(208) 852-0137
Mailing address
PO BOX 403, PRESTON, ID 83263-0403
(208) 523-4906
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-26
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004368700
—
ID
01
—
P00398960
RAILROAD MEDICARE
—
Enumeration date
07/27/2006
Last updated
09/08/2008
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