Healthcare Provider Details

I. General information

NPI: 1013260959
Provider Name (Legal Business Name): DAWN M. HOLMES MS, RD, CSSD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2012
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 OLENTANGY RIVER RD SUITE 260
COLUMBUS OH
43214-3467
US

IV. Provider business mailing address

906 PLEASANT RIDGE AVE
BEXLEY OH
43209-2430
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-2786
  • Fax: 614-533-6609
Mailing address:
  • Phone: 614-441-6872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number6159
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: