Individual
MRS. KELLY HOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
70 REMICK BLVD, SPRINGBORO, OH 45066-9168
(937) 885-0701
(937) 885-0702
Mailing address
2912 SPRINGBORO RD, SUITE 201, MORAINE, OH 45439-1674
(937) 297-8999
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
05201
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000932845
ANTHEM
OH
05
—
0129420
—
OH
Enumeration date
03/04/2015
Last updated
08/07/2015
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