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NPI Code Detail

MEDICARE: ROCKY HOLMES FNP

MEDICARE:   ROCKY  HOLMES  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPN8335TN
2363L00000XNurse PractitionerR685993MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1APN8335OTHERTNMEDICAL LICENSE

General Provider Information

NPI Number : 1407991086
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROCKY HOLMES FNP
Provider Business Mailing Address
First Line : 3856 HWY 57 WEST
Second Line : PO BOX 99
City : RAMER
State : TN
Zip : 38367
Country : US
Telephone Number : 731-645-6118
Fax Number : 731-645-8312
Provider Business Practice Location Address
First Line : 232 MARKET ST
Second Line :
City : FLOWOOD
State : MS
Zip : 39232-3339
Country : US
Telephone Number : 337-991-9276
Fax Number : 337-943-0846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 03/24/2017

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