Individual
KYLE JOSEPH HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
360 STATION DR STE 300, CRYSTAL LAKE, IL 60014-8003
(815) 455-1800
(815) 455-1875
Mailing address
360 STATION DR STE 300, CRYSTAL LAKE, IL 60014-8003
(815) 455-1800
(815) 455-1875
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209031072
IL
363LF0000X
Family Nurse Practitioner
2022015229
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022015229
APRN LICENSE NUMBER
MO
Enumeration date
04/29/2022
Last updated
01/14/2025
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