Provider Demographics
NPI:1700438181
Name:HOLMES, ALEXUS
Entity Type:Individual
Prefix:
First Name:ALEXUS
Middle Name:
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 1:3001 QUARTER CREEK LN APT 38
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-5215
Mailing Address - Country:US
Mailing Address - Phone:804-550-8259
Mailing Address - Fax:
Practice Address - Street 1:3001 QUARTER CREEK LN APT 38
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-5215
Practice Address - Country:US
Practice Address - Phone:804-550-8259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide