Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | DR.0057350 | CO |
Y | 111NI0900X | Internist | DR.0057350 | CO |
N | 207RI0200X | Infectious Disease | DR.0057350 | CO |
NPI | 1063851517 |
---|---|
Provider Name | Dr. Rebecca Elizabeth Holder |
First Address | Pueblo, CO 81008-1764 |
Second Address | Pueblo, CO 81005-2175 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2013 |
Last Update Date | 13/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
65155050 | (05) | CO |