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1508815051 NPI number — MICHELLE A HOLMES MS, CCC-SLP

NPI Number: 1508815051
Health Care Provider/Practitioner: MICHELLE A HOLMES MS, CCC-SLP

Information about “1508815051” NPI (MICHELLE A HOLMES MS, CCC-SLP) exists in 1508815051 in HTML format HTML  |  1508815051 in plain Text format TXT  |  1508815051 in PDF (Portable Document Format) PDF  |  1508815051 in an XML format XML  formats.

NPI Number : 1508815051 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508815051",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HOLMES",
    "FirstName": "MICHELLE",
    "MiddleName": "A",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MS, CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "IMEL",
    "OtherFirstName": "MICHELLE",
    "OtherMiddleName": "A",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MS,CCC-SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "111 TACOMA CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOWLING GREEN",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "42101-0780",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "910-723-8230",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "111 TACOMA CT",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOWLING GREEN",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "42101-0780",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "910-723-8230",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/10/2006",
    "LastUpdateDate": "09/23/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "5895",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "3820",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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