Provider Demographics
NPI:1326054057
Name:HOLMES, LINDSAY K (NP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:K
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 1:1415 PORTLAND AVE
Mailing Address - Street 2:SUITE480
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3038
Mailing Address - Country:US
Mailing Address - Phone:585-544-7979
Mailing Address - Fax:585-266-6877
Practice Address - Street 1:1415 PORTLAND AVE
Practice Address - Street 2:SUITE480
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3038
Practice Address - Country:US
Practice Address - Phone:585-544-7979
Practice Address - Fax:585-266-6877
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332479363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P15318Medicare UPIN