Provider Demographics
NPI:1427012137
Name:HOLCOMB, ELIZABETH P (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:P
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 2357
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002
Mailing Address - Country:US
Mailing Address - Phone:270-444-9625
Mailing Address - Fax:270-575-5458
Practice Address - Street 1:916 KENTUCKY AVE
Practice Address - Street 2:PADUCAH-MCCRACKEN COUNTY HEALTH CENTER
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-1955
Practice Address - Country:US
Practice Address - Phone:270-444-9631
Practice Address - Fax:270-442-8769
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYRN 1046991363L00000X
KYARNP 2120P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
0279505Medicare ID - Type Unspecified
0279705Medicare ID - Type Unspecified
0279305Medicare ID - Type Unspecified
0278705Medicare ID - Type Unspecified
0279205Medicare ID - Type Unspecified
0279605Medicare ID - Type Unspecified
NPP000Medicare UPIN