Individual
CHERYL HOLTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
ATTN: MCHJ-CLQ-C, 9040 JACKSON AVENUE, TACOMA, WA 98431-1100
(719) 524-6607
Mailing address
ATTN: MCHJ-CLQ-C, 9040 JACKSON AVENUE, TACOMA, WA 98431-1100
(719) 524-6607
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
167272
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167272
TBN TEXAS
TX
Enumeration date
02/22/2021
Last updated
02/22/2021
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