Provider Demographics
NPI:1821638057
Name:HOLSTEIN, LEEVETTA LYNN (APRN-FNP)
Entity Type:Individual
Prefix:
First Name:LEEVETTA
Middle Name:LYNN
Last Name:HOLSTEIN
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 LYNN AVE
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:WV
Mailing Address - Zip Code:25523-1138
Mailing Address - Country:US
Mailing Address - Phone:304-824-5806
Mailing Address - Fax:304-824-5804
Practice Address - Street 1:10008 COAL RIVER RD
Practice Address - Street 2:
Practice Address - City:SETH
Practice Address - State:WV
Practice Address - Zip Code:25181-0611
Practice Address - Country:US
Practice Address - Phone:304-837-3399
Practice Address - Fax:304-854-1031
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV105405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily