Provider Demographics
NPI:1003516006
Name:HOLBEN, ALISHA KRISTINE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:KRISTINE
Last Name:HOLBEN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16424 FERN CIR
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-4886
Mailing Address - Country:US
Mailing Address - Phone:276-623-7851
Mailing Address - Fax:
Practice Address - Street 1:560 S BELLVIEW
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-2504
Practice Address - Country:US
Practice Address - Phone:276-623-7851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ288878363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health