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MARY R. HOLT CPNP
NPI 1073772984
Nurse Practitioner - Pediatrics in Grand Rapids, MI

Active since June 05, 2008
935 BAXTER ST SE, GRAND RAPIDS, MI 49506(616) 456-5310(616) 456-8640 Get Directions Write a Review

NPPES record last updated: June 5, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary R. Holt Cpnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY R. HOLT CPNP (NPI 1073772984) is an individual pediatrics provider in Grand Rapids, Michigan, licensed in Michigan (4704109296) and active in the NPI registry since June 2008.

NPPES Registry Identity

NPI1073772984
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameMARY R. HOLTCredential: CPNP
Location Address935 BAXTER ST SEGrand Rapids, MI 49506-2500
Mailing Address935 Baxter St SeGrand Rapids, MI 49506-2599 · (616) 456-5310 · Fax (616) 456-8640
Phone(616) 456-5310
Fax(616) 456-8640
Sole ProprietorNo
Enumeration DateJune 5, 2008
✔ NPI 1073772984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in MI · 4704109296
935 BAXTER ST SE, Grand Rapids, MI 49506
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Other Identifiers 1

Medicaid2742857MI

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Holt's NPI number?

The NPI number for Mary Holt is 1073772984. It was assigned to this individual provider in the NPPES registry on June 5, 2008.

Where is Mary Holt located?

Mary Holt practices at 935 Baxter St SE, Grand Rapids, MI 49506. The listed phone number is (616) 456-5310.

What is Mary Holt's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Mary Holt was last updated on June 5, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.