Provider Demographics
NPI:1013009273
Name:HOLMES, ELIZABETH M (ARNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:HOLMES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:M
Other - Last Name:RUDSIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 1627
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273
Mailing Address - Country:US
Mailing Address - Phone:360-708-9741
Mailing Address - Fax:801-780-9741
Practice Address - Street 1:1911 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-6703
Practice Address - Country:US
Practice Address - Phone:360-708-9741
Practice Address - Fax:360-588-4192
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007181363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health