Provider Demographics
NPI:1689121881
Name:HOLT, ANDREA (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:HOLT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:BOULDIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8367 ARBORCREST DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-1403
Mailing Address - Country:US
Mailing Address - Phone:513-602-2643
Mailing Address - Fax:
Practice Address - Street 1:3200 VINE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2213
Practice Address - Country:US
Practice Address - Phone:513-602-2643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029137363LF0000X
OH422140163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily