Provider Demographics
NPI:1891550513
Name:HOLMS, AMBRIA LASHON
Entity Type:Individual
Prefix:
First Name:AMBRIA
Middle Name:LASHON
Last Name:HOLMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 STERLINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:FARMERVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71241-3122
Mailing Address - Country:US
Mailing Address - Phone:318-309-1449
Mailing Address - Fax:318-309-1317
Practice Address - Street 1:511 STERLINGTON HWY
Practice Address - Street 2:
Practice Address - City:FARMERVILLE
Practice Address - State:LA
Practice Address - Zip Code:71241-3122
Practice Address - Country:US
Practice Address - Phone:318-309-1449
Practice Address - Fax:318-309-1317
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty