Individual
MS. AMY MARIE HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
400 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63110-1014
(314) 362-9123
(314) 747-3338
Mailing address
660 S EUCLID AVE, CB 8072, SAINT LOUIS, MO 63110-1010
(314) 362-9123
(314) 747-3338
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2013030761
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679900740
—
MO
05
—
ENROLLED
—
IL
Enumeration date
10/03/2013
Last updated
06/13/2019
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