Healthcare Provider Details

I. General information

NPI: 1750777827
Provider Name (Legal Business Name): JANICE P. HOLMES MSN,APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 GEORGES LN
MONROE CT
06468-3138
US

IV. Provider business mailing address

87 GEORGES LN
MONROE CT
06468-3138
US

V. Phone/Fax

Practice location:
  • Phone: 203-452-5241
  • Fax:
Mailing address:
  • Phone: 203-452-5241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number001855
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: