| Doctor Name: | MRS. DONNA CAROL HOLT - COSTAIN |
| NPI Number: | 1144215393 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN,BC |
| License Number: | 2000168672 |
| Business Practice Address: | 70 Jungermann Cir Suite 101 St Peters, MO - 633761622 |
| Business Phone Number: | 6369260404 |
| Business Fax Number: | 6369393218 |
| Mailing Address: | 70 Jungermann Cir, Suite 101 ST PETERS |
| State: | MO |
| Postal Code: | 633761622 |
| Phone Number: | 6369260404 |
| Fax Number: | 6369393218 |
| NPI Enumeration Date: | 09/14/2005 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2000168672 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |