Provider Demographics
NPI:1891261194
Name:HOLMAN, ANESSA LEE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ANESSA
Middle Name:LEE
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 HALIFAX DR STE 102
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6991
Mailing Address - Country:US
Mailing Address - Phone:270-925-6403
Mailing Address - Fax:
Practice Address - Street 1:1020 HALIFAX DR STE 102
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6991
Practice Address - Country:US
Practice Address - Phone:270-713-0799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012789363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health