Provider Demographics
NPI:1508536442
Name:HOLMES, FELICIA NICHELLE
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:NICHELLE
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 1:5078 BENNING RD SE APT A6
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5869
Mailing Address - Country:US
Mailing Address - Phone:202-560-1597
Mailing Address - Fax:
Practice Address - Street 1:206 WAYNE PL SE APT G2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3063
Practice Address - Country:US
Practice Address - Phone:202-574-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant