Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 498 | AK |
NPI | 1780676502 |
---|---|
Provider Name | Susan J Holit |
First Address | Soldotna, AK 99669-2949 |
Second Address | Soldotna, AK 99669-7636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 03/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P58798 | (02) | |
RH177FQ | (05) | AK |