Provider Demographics
NPI:1629491808
Name:HOLDEN, ALISHA
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:HOLDEN
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:USAMEDDAC-JAPAN
Mailing Address - Street 2:UNIT 45011
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96338-5011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USAMEDDAC-JAPAN
Practice Address - Street 2:UNIT 45011
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:93668-5011
Practice Address - Country:US
Practice Address - Phone:315-263-3947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001193655163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management