| Doctor Name: | MRS. GWYNETH LEIGH HOLDERBY |
| NPI Number: | 1124447305 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DNP |
| License Number: | 96130 |
| Business Practice Address: | 800 Share Dr Alva, OK - 737173618 |
| Business Phone Number: | 5803272800 |
| Business Fax Number: | |
| Mailing Address: | Rr 1 Box 354, BYRON |
| State: | OK |
| Postal Code: | 737229507 |
| Phone Number: | 4058804714 |
| Fax Number: | |
| NPI Enumeration Date: | 04/15/2014 |
| NPI Last Update Date: | 06/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 96130 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |