Provider Demographics
NPI:1679875330
Name:HOLMAN, MARISOL (CPM, CDEM)
Entity Type:Individual
Prefix:MS
First Name:MARISOL
Middle Name:
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:CPM, CDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 CLEARVISTA PKWY STE 8B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1456
Mailing Address - Country:US
Mailing Address - Phone:137-436-8306
Mailing Address - Fax:
Practice Address - Street 1:8202 CLEARVISTA PKWY STE 8B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1456
Practice Address - Country:US
Practice Address - Phone:317-436-8306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife