Provider Demographics
NPI:1851630438
Name:HOLT, JESSICA L (CRNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:HOLT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-8329
Mailing Address - Country:US
Mailing Address - Phone:724-986-2792
Mailing Address - Fax:
Practice Address - Street 1:5 SAINT FRANCIS WAY
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-5119
Practice Address - Country:US
Practice Address - Phone:724-772-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-02
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012391363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily