Doctor Name: | MR. BARRY ROBERT HOLTE |
NPI Number: | 1306087788 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | APRN, BC |
License Number: | 2006011274 |
Business Practice Address: | 4881 Sugar Maple Dr 88mdg/sgohc Wright Patterson Afb, OH - 454335546 |
Business Phone Number: | 9372576876 |
Business Fax Number: | 9376561192 |
Mailing Address: | 4881 Sugar Maple Dr, 88mdg/sgohc WRIGHT PATTERSON AFB |
State: | OH |
Postal Code: | 454335546 |
Phone Number: | 9372576876 |
Fax Number: | 9376561192 |
NPI Enumeration Date: | 03/16/2009 |
NPI Last Update Date: | 03/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 2006011274 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |