Provider Demographics
NPI:1417483983
Name:HOLTHAM-KEATHLEY, ANAND E E (RN, BSN)
Entity Type:Individual
Prefix:MR
First Name:ANAND
Middle Name:E E
Last Name:HOLTHAM-KEATHLEY
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 N POLK ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-7101
Mailing Address - Country:US
Mailing Address - Phone:541-525-2398
Mailing Address - Fax:
Practice Address - Street 1:151 W 7TH AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-1100
Practice Address - Country:US
Practice Address - Phone:541-525-2398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201404272RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse