Alan D Holt, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Preston, ID
NPI 1104840487 · NPPES record last updated Sep 8, 2008
Key facts
- NPI
- 1104840487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- RNA-26 (ID)
- Practice address
- 44 N 1St E
Preston, ID 83263-1326 - Phone
- (208) 852-0137
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RNA-26 | ID | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blackfoot Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Alan D Holt | Nurse Anesthetist, Certified Registered | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RNA-26 | ID | Yes |
Addresses
Primary practice location
44 N 1St E
Preston, ID 83263-1326
Mailing address
PO Box 403
Preston, ID 83263-0403
Phone (208) 523-4906
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00398960 | Other | RAILROAD MEDICARE | |
| 004368700 | Medicaid | ID |
Other providers in Preston, ID
- Seth William Haslam
- Health West, Inc.
- Healthy Care Solutions
- Lance Henderson
- Aaron Henrie
- Natalie J Hopper
- Karen Hull
- Thomas Richard Hull
- Idaho Dept of Health & Welfare Reg 6 Amh PSR Pres
- Ihc Health Services Inc
All providers in Preston, ID · Certified Registered Nurse Anesthetist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.