Provider Demographics
NPI:1710611181
Name:HOLMES, BRANDY MARIE (RN)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:MARIE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 N MORRISON RD
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5568
Mailing Address - Country:US
Mailing Address - Phone:765-254-5614
Mailing Address - Fax:765-254-5603
Practice Address - Street 1:3401 N MORRISON RD
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5568
Practice Address - Country:US
Practice Address - Phone:765-254-5614
Practice Address - Fax:765-254-5603
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28151354A163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator