MEDICARE: JESSICA LYNN HOLMES FNP

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
1	363LF0000X	Family Nurse Practitioner	357664	NY

General Provider Information

NPI Number	:	1184501462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LYNN HOLMES FNP

Provider Business Mailing Address
First Line	:	222 E 41ST ST FL 11
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-6739
Country	:	US
Telephone Number	:	646-824-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 E 41ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-6739
Country	:	US
Telephone Number	:	646-825-6353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	01/04/2026

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