Provider Demographics
NPI:1306002639
Name:HOLT-KNOX, SARA PATRICIA (ARNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:PATRICIA
Last Name:HOLT-KNOX
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24261 N US HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:HOODSPORT
Mailing Address - State:WA
Mailing Address - Zip Code:98548-9456
Mailing Address - Country:US
Mailing Address - Phone:360-432-7781
Mailing Address - Fax:
Practice Address - Street 1:24261 N US HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:HOODSPORT
Practice Address - State:WA
Practice Address - Zip Code:98548-9456
Practice Address - Country:US
Practice Address - Phone:360-432-7781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIP60032489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily