Provider Demographics
NPI:1346029352
Name:HOLMES, BREEANNA CAMILLE (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:BREEANNA
Middle Name:CAMILLE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6480 OLD WATERLOO RD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6508
Mailing Address - Country:US
Mailing Address - Phone:410-799-0291
Mailing Address - Fax:
Practice Address - Street 1:6480 OLD WATERLOO RD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6508
Practice Address - Country:US
Practice Address - Phone:410-799-0291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR229666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily