Provider Demographics
NPI:1275636763
Name:ALLEN-HOLMES, LINDA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:ALLEN-HOLMES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24224 PRIMULA COURT
Mailing Address - Street 2:
Mailing Address - City:LAYTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20882
Mailing Address - Country:US
Mailing Address - Phone:301-482-0091
Mailing Address - Fax:
Practice Address - Street 1:2501 MUSGROVE ROAD
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:301-890-5552
Practice Address - Fax:301-890-2049
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR157592363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S96876Medicare UPIN
MD019294H76Medicare ID - Type Unspecified