Provider Demographics
NPI:1952429573
Name:HOLTON, KATHERINE (LPN)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:HOLTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:113 MOSEYWOOD RD
Mailing Address - City:LAKE HARMONY
Mailing Address - State:PA
Mailing Address - Zip Code:18624-0163
Mailing Address - Country:US
Mailing Address - Phone:570-722-1332
Mailing Address - Fax:
Practice Address - Street 1:113 MOSEYWOOD RD
Practice Address - Street 2:
Practice Address - City:LAKE HARMONY
Practice Address - State:PA
Practice Address - Zip Code:18624-0163
Practice Address - Country:US
Practice Address - Phone:570-722-1332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN152230L164W00000X
NJ26NP02192400164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse