MEDICARE: MRS. LASHAN HOLMAN BSN, RN

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	163W00000X	Registered Nurse	0001263890	VA

General Provider Information

NPI Number	:	1548837495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LASHAN HOLMAN BSN, RN

Provider Business Mailing Address
First Line	:	11357 NUCKOLS RD # 1164
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-5504
Country	:	US
Telephone Number	:	804-223-4010
Fax Number	:

Provider Business Practice Location Address
First Line	:	2809 SEIBEL RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-2041
Country	:	US
Telephone Number	:	804-223-4010
Fax Number	:

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

Provider Enumeration Date	:	06/09/2021
Last Update Date	:	06/09/2021

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