Provider Demographics
NPI:1770800013
Name:HOLT, SHELLEY ANN (DNS)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:ANN
Last Name:HOLT
Suffix:
Gender:F
Credentials:DNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 SHANNON RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079
Mailing Address - Country:US
Mailing Address - Phone:603-894-1260
Mailing Address - Fax:603-458-2160
Practice Address - Street 1:73 SHANNON RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079
Practice Address - Country:US
Practice Address - Phone:603-894-1260
Practice Address - Fax:603-458-2160
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHO33667-31163WH0200X
NH033667-31251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health