Provider Demographics
NPI:1689398323
Name:HOLTON, CINDY LOU
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:LOU
Last Name:HOLTON
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 1:328 NORFOLK AVE.
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5233
Mailing Address - Country:US
Mailing Address - Phone:402-379-2268
Mailing Address - Fax:402-371-7631
Practice Address - Street 1:328 NORFOLK AVE.
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5233
Practice Address - Country:US
Practice Address - Phone:402-379-2268
Practice Address - Fax:402-371-7631
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NECPSS-174175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist