Basic Information
| Provider Information | |||||||||
| NPI: | 1093346322 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOLTAN | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 UNION RD | ||||||||
| Address2: | |||||||||
| City: | STRATHAM | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038852423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037700115 | ||||||||
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| Practice Location | |||||||||
| Address1: | 207 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | NEWMARKET | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038571835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036592494 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2020 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 072319-21 | NH | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 363LF0000X | 072319-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.