Provider Demographics
NPI:1972893311
Name:HOLMES, JUDITH T
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:T
Last Name:HOLMES
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 1:5853 MIDRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63051-1705
Mailing Address - Country:US
Mailing Address - Phone:636-677-8379
Mailing Address - Fax:
Practice Address - Street 1:7452 RIVERMONT TRL
Practice Address - Street 2:
Practice Address - City:HOUSE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:63051-2085
Practice Address - Country:US
Practice Address - Phone:314-650-0508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula