Provider Demographics
NPI:1194884437
Name:HOLT, CARLA C (RN NP)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:C
Last Name:HOLT
Suffix:
Gender:F
Credentials:RN NP
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Other - Credentials:
Mailing Address - Street 1:99 JESSIE HILL JR DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3155 ROYAL DRIVE
Practice Address - Street 2:SUITE 125
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-2430
Practice Address - Country:US
Practice Address - Phone:404-332-1861
Practice Address - Fax:404-893-6745
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN030744NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner