Provider Demographics
NPI:1891935854
Name:HOLDER, JANIE GALE
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:GALE
Last Name:HOLDER
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 1:270 COUNTY ROAD 635
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-6340
Mailing Address - Country:US
Mailing Address - Phone:423-506-8772
Mailing Address - Fax:
Practice Address - Street 1:393 SHOWBARN RD.
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37371
Practice Address - Country:US
Practice Address - Phone:423-745-7431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN87453163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse