Provider Demographics
NPI:1306087788
Name:HOLTE, BARRY ROBERT (APRN, BC)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:ROBERT
Last Name:HOLTE
Suffix:
Gender:M
Credentials:APRN, BC
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Mailing Address - Street 1:4881 SUGAR MAPLE DR
Mailing Address - Street 2:88MDG/SGOHC
Mailing Address - City:WRIGHT PATTERSON AFB
Mailing Address - State:OH
Mailing Address - Zip Code:45433-5546
Mailing Address - Country:US
Mailing Address - Phone:937-257-6876
Mailing Address - Fax:937-656-1192
Practice Address - Street 1:4881 SUGAR MAPLE DR
Practice Address - Street 2:88MDG/SGOHC
Practice Address - City:WRIGHT PATTERSON AFB
Practice Address - State:OH
Practice Address - Zip Code:45433-5546
Practice Address - Country:US
Practice Address - Phone:937-257-6876
Practice Address - Fax:937-656-1192
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH2006011274363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health