Provider Demographics
NPI:1922301043
Name:HOLMES, TAMMY L (RN/ NUTRITIONIST)
Entity Type:Individual
Prefix:MISS
First Name:TAMMY
Middle Name:L
Last Name:HOLMES
Suffix:
Gender:F
Credentials:RN/ NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E 2ND AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-1200
Mailing Address - Country:US
Mailing Address - Phone:908-245-1400
Mailing Address - Fax:
Practice Address - Street 1:111 E 2ND AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-1200
Practice Address - Country:US
Practice Address - Phone:908-245-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-11
Last Update Date:2010-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education