Holt, Shannon L

Holt, Shannon L is an individual health care provider with primary practice located at 1115 Woodland Dr , Elizabethtown KY 42701-2749. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Gynecology is her primary health care specialty. Holt, Shannon L can be contacted via phone (270) 769-5963.

Contact Information

Primary practice address
1115 Woodland Dr Elizabethtown KY 42701-2749
Phone: (270) 769-5963
Fax: (270) 769-9051
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 37416 Kentucky
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 37416 Kentucky

Profile Details

NPI number 1033153085
LBN Legal business name Holt, Shannon L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Nov 9th, 2009 - about 15 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 1033153085 NPPES
Kentucky MEDICAID 64085442

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