Holder, Autumn Elizabeth

Holder, Autumn Elizabeth is an individual health care provider with primary practice located at 120 E Beauregard Ave , San Angelo TX 76903-5919. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Naturopath, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Holder, Autumn Elizabeth can be contacted via phone (325) 658-1511.

Contact Information

Primary practice address
120 E Beauregard Ave San Angelo TX 76903-5919
Phone: (325) 658-1511
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Naturopath 175F00000X 399 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3042 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA07863 Texas

Profile Details

NPI number 1922059369
LBN Legal business name Holder, Autumn Elizabeth
Credentials NMD, PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Sep 15th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922059369 NPPES
Arizona MEDICAID 911009

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