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General NPI Number Information
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NPI Number | 1992109805
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Entity Type | Individual
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Provider Name | JESSICA ELIZABETH HOLMES CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/21/2014
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 1814 BEL AIR RD STE 300
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City | FALLSTON
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State | MD
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Zip | 21047-2730
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Country | US
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Telephone | 410-694-7411
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Fax | 410-694-7410
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Provider Business Mailing Address
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Address Line | 1814 BEL AIR RD STE 300
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City | FALLSTON
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State | MD
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Zip | 21047-2730
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Country | US
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Telephone | 410-694-7411
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Fax | 410-684-7410
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R178339
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R178339
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R178339
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License Number State | MD
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