Provider Demographics
NPI:1467865964
Name:HOLT, KARLA J (LM, CPM)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:J
Last Name:HOLT
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MYRTLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-5632
Mailing Address - Country:US
Mailing Address - Phone:813-949-1185
Mailing Address - Fax:813-949-1162
Practice Address - Street 1:106 MYRTLE RIDGE RD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-5632
Practice Address - Country:US
Practice Address - Phone:813-949-1185
Practice Address - Fax:813-949-1162
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW293176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife