Provider Demographics
NPI:1043090095
Name:HOLMES, ASHLEY MARIE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 BINGAMON RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26591
Mailing Address - Country:US
Mailing Address - Phone:304-590-8817
Mailing Address - Fax:
Practice Address - Street 1:349 BINGAMON RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:WV
Practice Address - Zip Code:26591
Practice Address - Country:US
Practice Address - Phone:304-590-8817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant