Individual
MR. PAUL KELLY HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
2603 KENTUCKY AVENUE, SUITE 303, PADUCAH, KY 42003
(270) 443-2900
(270) 443-7122
Mailing address
PO BOX 7626, PADUCAH, KY 42002-7626
(270) 443-2900
(270) 443-7122
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2980P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
354856
ANTHEM INDIVIDUAL
KY
05
—
78014891
—
KY
Enumeration date
10/23/2006
Last updated
10/27/2009
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