Provider Demographics
NPI:1013217876
Name:HOLMES, LAFITTE JERMAINE SR (CLINICAL NURSE SPEC)
Entity Type:Individual
Prefix:MR
First Name:LAFITTE
Middle Name:JERMAINE
Last Name:HOLMES
Suffix:SR
Gender:M
Credentials:CLINICAL NURSE SPEC
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Mailing Address - Street 1:4212 E SOUTHCROSS BLVD
Mailing Address - Street 2:STE # 145
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-3735
Mailing Address - Country:US
Mailing Address - Phone:210-447-3033
Mailing Address - Fax:210-447-3036
Practice Address - Street 1:4212 E SOUTHCROSS BLVD
Practice Address - Street 2:STE # 145
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3735
Practice Address - Country:US
Practice Address - Phone:210-447-3033
Practice Address - Fax:210-447-3036
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-28
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Provider Licenses
StateLicense IDTaxonomies
TX667360364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health