Provider Demographics
NPI:1477187722
Name:HOLT-CAPUTO, MARY FRANCES
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:HOLT-CAPUTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1503
Mailing Address - Country:US
Mailing Address - Phone:410-310-6483
Mailing Address - Fax:
Practice Address - Street 1:479 THOMAS JONES WAY STE 650
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2575
Practice Address - Country:US
Practice Address - Phone:443-679-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021569363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner