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General NPI Number Information
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NPI Number | 1134810740
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Entity Type | Individual
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Provider Name | HEATHER MARIE HOLMES APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 3925 N LECANTO HWY
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-3507
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Country | US
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Telephone | 352-697-7336
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2066
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City | LECANTO
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State | FL
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Zip | 34460-2066
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Country | US
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Telephone | 352-697-7336
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11026350
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License Number State | FL
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