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General NPI Number Information
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NPI Number | 1518341965
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Entity Type | Individual
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Provider Name | DIANE KAY HOLMES NP
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Gender | Female
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 4154 W VIENNA RD STE A
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City | CLIO
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State | MI
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Zip | 48420-2807
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Country | US
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Telephone | 810-686-3747
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Fax |
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Provider Business Mailing Address
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Address Line | 3495 S CENTER RD
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City | BURTON
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State | MI
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Zip | 48519-1455
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704221124
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License Number State | MI
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