MEDICARE: MR. JACE AARON 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	AP09344	LA

General Provider Information

NPI Number	:	1346778123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JACE AARON HOLMES FNP

Provider Business Mailing Address
First Line	:	417 E LINCOLN RD
Second Line	:
City	:	VILLE PLATTE
State	:	LA
Zip	:	70586-3431
Country	:	US
Telephone Number	:	337-363-7744
Fax Number	:

Provider Business Practice Location Address
First Line	:	417 E LINCOLN RD
Second Line	:
City	:	VILLE PLATTE
State	:	LA
Zip	:	70586-3431
Country	:	US
Telephone Number	:	337-363-7744
Fax Number	:

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

Provider Enumeration Date	:	05/24/2017
Last Update Date	:	07/21/2022

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