Individual
STACEY LYNN HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1800 ALLENTOWN RD, LIMA, OH 45805-1873
(614) 795-0311
Mailing address
235 MILL ST, PATASKALA, OH 43062-8852
(614) 795-0311
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN355876
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP0032773
OH
Other
Enumeration date
03/15/2022
Last updated
12/07/2022
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