Individual
KELLY HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 HERITAGE DR, BOSSIER CITY, LA 71112-8717
(318) 746-3131
Mailing address
400 HERITAGE DR, BOSSIER CITY, LA 71112-8717
(318) 746-3131
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN074983
LA
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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