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General NPI Number Information
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NPI Number | 1306006002
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Entity Type | Individual
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Provider Name | FELICIA E. HOLSTON LPN
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Gender | Female
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 103 FRANKLIN SQ
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City | BONAIRE
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State | GA
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Zip | 31005-3244
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Country | US
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Telephone | 478-396-0506
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Fax |
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Provider Business Mailing Address
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Address Line | 103 FRANKLIN SQ
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City | BONAIRE
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State | GA
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Zip | 31005-3244
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Country | US
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Telephone | 478-396-0506
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | P05580
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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