Provider Demographics
NPI:1487687935
Name:HOLTE, DEBORAH AK (DPM)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:AK
Last Name:HOLTE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-1239
Mailing Address - Country:US
Mailing Address - Phone:573-406-5930
Mailing Address - Fax:573-248-5448
Practice Address - Street 1:1405 CROWN DR
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-2570
Practice Address - Country:US
Practice Address - Phone:660-665-9000
Practice Address - Fax:660-665-8445
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000684213EP1101X, 213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO306652512Medicaid
U37717Medicare UPIN
MO0534440001Medicare NSC
MO990001494Medicare PIN