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NPI Code Detail

MEDICARE: EVA RENEE HOLMES RN

MEDICARE: EVA RENEE HOLMES RN
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
1163WG0000XGeneral Practice Registered Nurse124025AK

General Provider Information

NPI Number : 1740744457
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVA RENEE HOLMES RN
Provider Business Mailing Address
First Line : 1711 LORE RD APT 212
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-2968
Country : US
Telephone Number : 907-250-5157
Fax Number :
Provider Business Practice Location Address
First Line : 670 W FIREWEED LN STE 160
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2561
Country : US
Telephone Number : 907-770-0862
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2019
Last Update Date : 01/27/2019

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