Individual
BRENDA E HOLTSCLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 431-6111
Mailing address
1009 LARK ST STE 2, JOHNSON CITY, TN 37604-8218
(423) 283-0776
(423) 283-0549
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN0000081278
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3626122
—
TN
Enumeration date
08/16/2005
Last updated
04/24/2019
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