Provider Demographics
NPI:1497979769
Name:HOLTZ, RENITA BARBARA (RNFA)
Entity Type:Individual
Prefix:MS
First Name:RENITA
Middle Name:BARBARA
Last Name:HOLTZ
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 OAK LN
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-3117
Mailing Address - Country:US
Mailing Address - Phone:973-361-2729
Mailing Address - Fax:973-361-3478
Practice Address - Street 1:10 OAK LN
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-3117
Practice Address - Country:US
Practice Address - Phone:973-361-2729
Practice Address - Fax:973-361-3478
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061101163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant