Provider Demographics
NPI:1023453834
Name:HOLMAN, HEATHER LAUREN (LM)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LAUREN
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 EAST IDAHO STREET
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-260-5105
Mailing Address - Fax:406-758-0283
Practice Address - Street 1:119 EAST IDAHO STREET
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-260-5105
Practice Address - Fax:406-758-0283
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTAHC-MID-LIC-867176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife