Individual
PHILIP HOLTGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1993 WENTZVILLE PKWY, WENTZVILLE, MO 63385-3424
(314) 687-2732
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-0551
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
145838
MO
363L00000X
Nurse Practitioner
209005604
IL
364SF0001X
Family Health Clinical Nurse Specialist
145838
MO
Other
Enumeration date
03/31/2008
Last updated
10/22/2020
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