Healthcare Provider Details

I. General information

NPI: 1366020398
Provider Name (Legal Business Name): KYANA L HOLMES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W ALABAMA ST
HOUSTON TX
77006-5161
US

IV. Provider business mailing address

315 W ALABAMA ST STE 200
HOUSTON TX
77006-5177
US

V. Phone/Fax

Practice location:
  • Phone: 281-509-3924
  • Fax:
Mailing address:
  • Phone: 281-509-3924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number751069
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: