SHANNON HOLDER (NPI# 1477974764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477974764 |
| Entity Type | Individual |
| Full Name | SHANNON HOLDER |
| Credential | DNP, NP-C, PMHNP-BC |
| Practice Address |
1916 Crain Hwy S Ste 2 Glen Burnie MD 21061 |
| Mailing Address |
1916 Crain Hwy S Ste 2 Glen Burnie MD 21061-5565 |
| Practice Telephone | 4107937252 |
| Mailing Telephone | 4107624550 |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2019-12-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
R170448 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R170448 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1916 Crain Hwy S Ste 2, Glen Burnie, MD 210615565 | 4107624550 | |
| 1916 Crain Hwy S Ste 2, Glen Burnie, MD 21061 | 4107937252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336298165 | Shannon Holder | Counselor | 506 Glascow St, Victoria, TX 77904-1406 | 2007-01-10 |
| Street Address |
1916 CRAIN HWY S STE 2 |
| City | GLEN BURNIE |
| State | MD |
| Zip Code | 21061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134602303 | Holder Healthcare Consulting, LLC | Nurse Practitioner | 1916 Crain Hwy S Ste 2, Glen Burnie, MD 21061-5565 | 2018-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255814422 | Lotus Behavioral Health and Rehabilitation Services Inc. | Behavior Technician | 6426 Harrison Square, Glen Burnie, MD 21061 | 2018-09-12 |
| 1942795315 | Tina Brown | Behavior Technician | Rise for Autism, 510 Mccormick Drive, Ste. U-w, Glen Burnie, MD 21061 | 2018-06-27 |
| 1205351905 | Digna Emerita Sanchez De Vasquez | Specialist/Technologist, Other | 201 Fernglen Ave, Glen Burnie, MD 21061 | 2017-08-03 |
| 1255780300 | Rachel Cutts | Physical Therapist | 7711 Quarterfield Rd Ste C2, Glen Burnie, MD 21061 | 2016-06-09 |
| 1295181170 | Gaudenzia, Inc. | Counselor | 5 Crain Highway North - Rear Suite Entrance, Glen Burnie, MD 21061 | 2016-05-10 |
| 1023499548 | Mary Bourbon | Nurse Practitioner | 1600 S. Cain Highway, Suite 401, Glen Burnie, MD 21061 | 2015-06-10 |
| 1972997724 | Robert Oladeinde | Physician Assistant | 6934 Aviation Blvd Suite B, Glen Burnie, MD 21061 | 2015-03-18 |
| 1205248069 | Cathy Qing He | Anesthesiology | 1600 Crain Hwy S Ste 301, Glen Burnie, MD 21061 | 2014-05-28 |
| 1629404207 | Marla Ann Muha | Physician Assistant | 301 Hospital Dr # 803, Glen Burnie, MD 21061 | 2013-09-16 |
| 1902142839 | Behavioral Healthcare of Maryland | Clinic/Center | 1405 Madison Park Drive Suite 1b, Glen Burnie, MD 21061 | 2012-12-21 |
| Find all providers in zip 21061 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376177097 | Edith Osei | Nurse Practitioner | 718 Columbus Dr, Glen Burnie, MD 21061-4990 | 2020-03-03 |
| 1437798923 | Ic Health Services Inc | Nurse Practitioner | 6710f Ritchie Hwy Ste 417, Glen Burnie, MD 21061-2319 | 2019-12-31 |
| 1003450206 | Equillibrium Health Care Services LLC | Nurse Practitioner | 6710f Ritchie Hwy # 417, Glen Burnie, MD 21061-2319 | 2019-10-30 |
| 1508428541 | Body Mind & Soul Family Services, LLC | Nurse Practitioner | 1401 Madison Park Dr Ste 201, Glen Burnie, MD 21061-5881 | 2019-06-30 |
| 1427317080 | Martin Nkemamin Nzefeh | Nurse Practitioner | 1406 Crain Hwy S # 104-106, Glen Burnie, MD 21061-4058 | 2012-05-16 |
| 1467460865 | Ilya Rozenberg | Nurse Practitioner | 7452 Baltimore Annapolis Blvd, Suite 107, Glen Burnie, MD 21061-3547 | 2006-08-03 |
| 1821696196 | Lacreasha Fullard | Nurse Practitioner | 7207 Baltimore Annapolis Blvd, Glen Burnie, MD 21061-2684 | 2020-10-09 |
| 1831702539 | Seven 2 Seven Medical Services LLC | Nurse Practitioner | 7678 Quarterfield Rd Ste 201, Glen Burnie, MD 21061-7071 | 2020-08-24 |
| 1003426065 | Epm Health Services | Nurse Practitioner | 718 Columbus Dr, Glen Burnie, MD 21061-4990 | 2020-08-05 |
| 1053961987 | Michael Nwandu | Nurse Practitioner | 7836 Oakwood Rd, Glen Burnie, MD 21061-4298 | 2019-09-12 |
| Find all providers in GLEN BURNIE | ||||
| City | GLEN BURNIE |
| Zip Code | 21061 |
Please comment or provide details below to improve the information on SHANNON HOLDER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.