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General NPI Number Information
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NPI Number | 1538053079
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Entity Type | Individual
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Provider Name | LANA J HOLMES LPN
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 30671 STEPHENSON HWY STE C
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-1652
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Country | US
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Telephone | 248-850-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 2467 CLEMENCEAU BLVD
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City | WINDSOR
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State | ONTARIO
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Zip | N8T2P4
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Country | CA
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 4703111134
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License Number State | MI
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