MEDICARE: MRS. MARIANNE LEAL HOLMES APRN, 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
1	363LF0000X	Family Nurse Practitioner	APN 116	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	APN 116	OTHER	SC	LICENSE

General Provider Information

NPI Number	:	1881652527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIANNE LEAL HOLMES APRN, FNP

Provider Business Mailing Address
First Line	:	PO BOX 9
Second Line	:
City	:	WALTERBORO
State	:	SC
Zip	:	29488-0001
Country	:	US
Telephone Number	:	843-844-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	719 OKATIE HWY # 170
Second Line	:
City	:	OKATIE
State	:	SC
Zip	:	29909-3963
Country	:	US
Telephone Number	:	843-987-7400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	03/07/2023

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