Provider Demographics
NPI:1750777827
Name:HOLMES, JANICE P (MSN,APRN)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:P
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MSN,APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 GEORGES LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-3138
Mailing Address - Country:US
Mailing Address - Phone:203-452-5241
Mailing Address - Fax:
Practice Address - Street 1:87 GEORGES LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-3138
Practice Address - Country:US
Practice Address - Phone:203-452-5241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001855364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult