Provider Demographics
NPI:1437956026
Name:HOLT, KAYLEE L
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:L
Last Name:HOLT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 1ST AVE E # 264
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:ND
Mailing Address - Zip Code:58782-4042
Mailing Address - Country:US
Mailing Address - Phone:360-824-0344
Mailing Address - Fax:
Practice Address - Street 1:208 1ST AVE E # 264
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:ND
Practice Address - Zip Code:58782-4042
Practice Address - Country:US
Practice Address - Phone:360-824-0344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide