Provider Demographics
NPI:1790091585
Name:HOLT, ALLISON MILLSAP (PA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MILLSAP
Last Name:HOLT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1020 J L WHITE DR STE 170
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-4910
Mailing Address - Country:US
Mailing Address - Phone:706-692-2437
Mailing Address - Fax:
Practice Address - Street 1:1020 J L WHITE DR STE 170
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-4910
Practice Address - Country:US
Practice Address - Phone:706-692-2437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant