Provider Demographics
NPI:1033562400
Name:HOLMES, MAUREEN ANN (MDHHS)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:ANN
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MDHHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3284 HILLARY CRK
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48519-2855
Mailing Address - Country:US
Mailing Address - Phone:810-610-0054
Mailing Address - Fax:
Practice Address - Street 1:3284 HILLARY CRK
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48519-2855
Practice Address - Country:US
Practice Address - Phone:810-610-0054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other