Provider Demographics
NPI:1760582969
Name:HOLMES, MARCY EMILY (NP)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:EMILY
Last Name:HOLMES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 STATE RD.
Mailing Address - Street 2:
Mailing Address - City:VINEYARD HAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02568-5624
Mailing Address - Country:US
Mailing Address - Phone:508-693-4400
Mailing Address - Fax:508-693-2098
Practice Address - Street 1:354 STATE RD.
Practice Address - Street 2:
Practice Address - City:VINEYARD HAVEN
Practice Address - State:MA
Practice Address - Zip Code:02568-5624
Practice Address - Country:US
Practice Address - Phone:508-693-4400
Practice Address - Fax:508-693-2098
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER046587363LW0102X
MARN210059363LW0102X
NYXXXXXXXXX363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMH0719419OtherDEA
MEUX2109Medicare PIN
MEMH0719419OtherDEA