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General NPI Number Information
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NPI Number | 1689469348
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Entity Type | Individual
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Provider Name | ADRIENNE HOLMES M.ED, LPN
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Gender | Female
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 107 SAINT FRANCIS DR
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City | PHILADELPHIA
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State | MS
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Zip | 39350-9276
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Country | US
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Telephone | 601-562-6146
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Fax |
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Provider Business Mailing Address
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Address Line | 562 STATE AVE
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City | PHILADELPHIA
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State | MS
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Zip | 39350-2792
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Country | US
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Telephone | 601-562-6146
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Fax | 601-562-6146
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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 | 334824
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 194265
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License Number State | MS
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