Provider Demographics
NPI:1467242271
Name:HOLTZ, KATHERINE ANNE (PA-C)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANNE
Last Name:HOLTZ
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3818 LISA LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001-9512
Mailing Address - Country:US
Mailing Address - Phone:859-663-6677
Mailing Address - Fax:
Practice Address - Street 1:950 BRECKENRIDGE LN STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-5929
Practice Address - Country:US
Practice Address - Phone:502-893-6777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTC037363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant