Provider Demographics
NPI:1922452028
Name:HOLBERT, ANTHONY L
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:L
Last Name:HOLBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 PITTS PL SE APT 303
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-4979
Mailing Address - Country:US
Mailing Address - Phone:202-290-9885
Mailing Address - Fax:
Practice Address - Street 1:1316 EUCLID ST NW APT CK8
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4831
Practice Address - Country:US
Practice Address - Phone:202-290-9885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-15
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNA00607833376K00000X
DCHHA12091374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide