Provider Demographics
NPI:1255692208
Name:HOLMES, ROSLYN G
Entity Type:Individual
Prefix:
First Name:ROSLYN
Middle Name:G
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 1:140 MICHIGAN AVE NE
Mailing Address - Street 2:APARTMENT T-12
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1039
Mailing Address - Country:US
Mailing Address - Phone:202-486-1133
Mailing Address - Fax:
Practice Address - Street 1:800 SOUTHERN AVENUE SE
Practice Address - Street 2:SUITE 827
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032
Practice Address - Country:US
Practice Address - Phone:202-574-1450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No172A00000XOther Service ProvidersDriver