Provider Demographics
NPI:1356958201
Name:HOLMAN, MEAGHAN VERONICA (MSN, NP-C, FNP)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:VERONICA
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:MSN, NP-C, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20565 STARINA DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-7503
Mailing Address - Country:US
Mailing Address - Phone:586-260-6868
Mailing Address - Fax:
Practice Address - Street 1:53960 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-1820
Practice Address - Country:US
Practice Address - Phone:586-323-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704250676163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse