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General NPI Number Information
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NPI Number | 1083998728
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Entity Type | Individual
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Provider Name | LAURA GEANINE HOLMES MS, RD, LD, CDE
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Gender | Female
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 1 MED CENTER DR
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City | CLARKSBURG
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State | WV
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Zip | 26301-4155
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Country | US
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Telephone | 304-623-3461
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Fax |
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Provider Business Mailing Address
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Address Line | 205 WOOD ST
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City | CLARKSBURG
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State | WV
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Zip | 26301-3129
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Country | US
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Telephone | 304-544-0319
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 747
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License Number State | WV
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