Healthcare Provider Details

I. General information

NPI: 1306997747
Provider Name (Legal Business Name): AMELIA HOLMES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2007
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1554 EMERALD OAKS AVE
HENDERSON NV
89014-2690
US

IV. Provider business mailing address

1554 EMERALD OAKS AVE
HENDERSON NV
89014-2690
US

V. Phone/Fax

Practice location:
  • Phone: 417-252-4441
  • Fax:
Mailing address:
  • Phone: 417-252-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number811519
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: