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General NPI Number Information
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NPI Number | 1326778036
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Entity Type | Individual
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Provider Name | ALEXIS C HOLMES
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Gender | Female
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Dates
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Enumeration Date | 06/15/2022
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 1289 ROUTE 38 STE 104
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City | HAINESPORT
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State | NJ
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Zip | 08036-2730
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Country | US
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Telephone | 609-288-3234
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Fax |
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Provider Business Mailing Address
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Address Line | 150 WEST AVE APT 1309
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City | WOODSTOWN
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State | NJ
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Zip | 08098-1149
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Country | US
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Telephone | 856-520-0568
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ01321600
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License Number State | NJ
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