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NPI Code Detail

MEDICARE: MS. HEATHER MARIE HOLMES APRN, FNP-BC

MEDICARE: MS. HEATHER MARIE HOLMES APRN, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner11026350FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111026350OTHERFLAPRN LICENSE

General Provider Information

NPI Number : 1134810740
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HEATHER MARIE HOLMES APRN, FNP-BC
Provider Business Mailing Address
First Line : PO BOX 2066
Second Line :
City : LECANTO
State : FL
Zip : 34460-2066
Country : US
Telephone Number : 352-697-7336
Fax Number :
Provider Business Practice Location Address
First Line : 3925 N LECANTO HWY
Second Line :
City : BEVERLY HILLS
State : FL
Zip : 34465-3507
Country : US
Telephone Number : 352-697-7336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2023
Last Update Date : 05/16/2023

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