Provider Demographics
NPI:1104001320
Name:HOLT, JENNIFER (DO)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:HOLT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1225 WARM SPRINGS AVENUE
Mailing Address - Street 2:JC BLAIR MEMORIAL HOSPITAL
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652
Mailing Address - Country:US
Mailing Address - Phone:814-643-8850
Mailing Address - Fax:814-643-8334
Practice Address - Street 1:1225 WARM SPRINGS AVENUE
Practice Address - Street 2:JC BLAIR MEMORIAL HOSPITAL
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652
Practice Address - Country:US
Practice Address - Phone:814-643-8850
Practice Address - Fax:814-643-8334
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS015040207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine