Individual
JENNIFER A HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3745 GEIST RD, FAIRBANKS, AK 99709-3554
(907) 456-3338
Mailing address
3745 GEIST RD, FAIRBANKS, AK 99709-3554
(907) 456-3338
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
150000
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500605570
—
OR
Enumeration date
05/27/2008
Last updated
11/19/2019
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