Provider Demographics
NPI:1821535600
Name:HOLMES, TAYLOR (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10606 SABLE CAP RD
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-3627
Mailing Address - Country:US
Mailing Address - Phone:919-608-3008
Mailing Address - Fax:
Practice Address - Street 1:4300 HWY 49 S
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-7527
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:704-454-5124
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHOLM-VKGFMG363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1821535600Medicaid