Provider Demographics
NPI:1922022482
Name:ALAN D HOLT
Entity Type:Organization
Organization Name:ALAN D HOLT
Other - Org Name:WESTERN ANESTHESIA RELIEF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:208-852-2709
Mailing Address - Street 1:PO BOX 403
Mailing Address - Street 2:
Mailing Address - City:PRESTON
Mailing Address - State:ID
Mailing Address - Zip Code:83263-0403
Mailing Address - Country:US
Mailing Address - Phone:208-523-4906
Mailing Address - Fax:
Practice Address - Street 1:44 NORTH 100 EAST
Practice Address - Street 2:
Practice Address - City:PRESTON
Practice Address - State:ID
Practice Address - Zip Code:83263
Practice Address - Country:US
Practice Address - Phone:208-852-0137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty