Healthcare Provider Details

I. General information

NPI: 1811826977
Provider Name (Legal Business Name): KATRINA HOLMES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 SOLOMONS ISLAND RD N
PRINCE FREDERICK MD
20678-3917
US

IV. Provider business mailing address

814 JOHNSWOODS RD
LUSBY MD
20657-2666
US

V. Phone/Fax

Practice location:
  • Phone: 410-535-5400
  • Fax:
Mailing address:
  • Phone: 240-672-2898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: