Provider Demographics
NPI:1093898173
Name:HOLT, ARTHUR RICHARD (LVN)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:RICHARD
Last Name:HOLT
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7887 QUAIL PARK WAY
Mailing Address - Street 2:
Mailing Address - City:ANTELOPE
Mailing Address - State:CA
Mailing Address - Zip Code:95843
Mailing Address - Country:US
Mailing Address - Phone:916-344-7099
Mailing Address - Fax:
Practice Address - Street 1:7805 AUBURN BLVD
Practice Address - Street 2:NORTHEAST HEALTH CENTER
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610
Practice Address - Country:US
Practice Address - Phone:916-969-9490
Practice Address - Fax:916-726-8903
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA152173164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse