Provider Demographics
NPI:1275281529
Name:HOLMES, HOPE LATRELL (NP)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:LATRELL
Last Name:HOLMES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 KINGS HWY UNIT 6
Mailing Address - Street 2:
Mailing Address - City:SUGAR LOAF
Mailing Address - State:NY
Mailing Address - Zip Code:10981-7502
Mailing Address - Country:US
Mailing Address - Phone:516-395-5471
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:516-395-5471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF310624-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty