Provider Demographics
NPI:1568039907
Name:HOLT, ELIZABETH M (RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:HOLT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5880 BRADFORD HICKS DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-2236
Mailing Address - Country:US
Mailing Address - Phone:931-823-6260
Mailing Address - Fax:931-823-5821
Practice Address - Street 1:5880 BRADFORD HICKS DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-2236
Practice Address - Country:US
Practice Address - Phone:931-823-6260
Practice Address - Fax:931-823-5821
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000246090163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse