Provider Demographics
NPI:1699380477
Name:HOLT, KATHERINE ELAINE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ELAINE
Last Name:HOLT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:333 NORTH SANTA ROSA STREET
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3108
Mailing Address - Country:US
Mailing Address - Phone:210-704-4100
Mailing Address - Fax:
Practice Address - Street 1:5210 THOUSAND OAKS DR.
Practice Address - Street 2:STE 1351
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233
Practice Address - Country:US
Practice Address - Phone:210-704-4005
Practice Address - Fax:210-704-4350
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX662696163WA2000X
TX1057096363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator