Provider Demographics
NPI:1720420441
Name:HOLMES, DANETTE GARNER (RN)
Entity Type:Individual
Prefix:MRS
First Name:DANETTE
Middle Name:GARNER
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 1:58405 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-3511
Mailing Address - Country:US
Mailing Address - Phone:225-953-0604
Mailing Address - Fax:225-238-2234
Practice Address - Street 1:58405 CANAL ST
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-3511
Practice Address - Country:US
Practice Address - Phone:225-953-0604
Practice Address - Fax:225-238-2234
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA70063163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse