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NPI Code Detail

MEDICARE: JACQUELINE PRISCILLIA HOLMES

MEDICARE:   JACQUELINE PRISCILLIA HOLMES
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
1376K00000XNurse's Aide136394FL

General Provider Information

NPI Number : 1790127967
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE PRISCILLIA HOLMES
Provider Business Mailing Address
First Line : 5834 ARUBA WAY
Second Line :
City : WEST PALM BCH
State : FL
Zip : 33407-1708
Country : US
Telephone Number : 904-554-0628
Fax Number :
Provider Business Practice Location Address
First Line : 5834 ARUBA WAY
Second Line :
City : WEST PALM BCH
State : FL
Zip : 33407-1708
Country : US
Telephone Number : 904-554-0628
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2013
Last Update Date : 02/19/2014

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Directions to “ JACQUELINE PRISCILLIA HOLMES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.