Provider Demographics
NPI:1134602303
Name:HOLDER HEALTHCARE CONSULTING, LLC
Entity type:Organization
Organization Name:HOLDER HEALTHCARE CONSULTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, NP-C, PMHNP-BC
Authorized Official - Phone:410-941-7260
Mailing Address - Street 1:1916 CRAIN HWY S STE 2
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5565
Mailing Address - Country:US
Mailing Address - Phone:410-762-4550
Mailing Address - Fax:
Practice Address - Street 1:1916 CRAIN HWY S STE 2
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5565
Practice Address - Country:US
Practice Address - Phone:410-762-4550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty