Provider Demographics
NPI:1518349307
Name:HOLTMAN, KAITLYN (NP-C)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:HOLTMAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:
Other - Last Name:IGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4355
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNETT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-636-4355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17657-NP363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH17657-NPOtherOHIO BOARD OF NURSING
OH17657-EX1OtherOHIO BOARD OF NURSING