Provider Demographics
NPI:1336613793
Name:HOLDEN, BRITNEY DAWN (CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:BRITNEY
Middle Name:DAWN
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W. IRONWOOD DRIVE
Mailing Address - Street 2:SUITE 155
Mailing Address - City:COEUR D'ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4462
Mailing Address - Country:US
Mailing Address - Phone:208-667-0585
Mailing Address - Fax:208-625-2075
Practice Address - Street 1:700 W. IRONWOOD DRIVE
Practice Address - Street 2:SUITE 155
Practice Address - City:COEUR D'ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4462
Practice Address - Country:US
Practice Address - Phone:208-667-0585
Practice Address - Fax:208-765-6075
Is Sole Proprietor?:No
Enumeration Date:2019-01-17
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP66498363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1336613793Medicaid