Provider Demographics
NPI:1801622691
Name:HOLMES, ASIA (CRNP)
Entity type:Individual
Prefix:
First Name:ASIA
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 LEWIS AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:EAST LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2694
Mailing Address - Country:US
Mailing Address - Phone:267-601-3177
Mailing Address - Fax:
Practice Address - Street 1:1001 BALTIMORE PIKE UNIT 10A
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2800
Practice Address - Country:US
Practice Address - Phone:610-604-0888
Practice Address - Fax:610-604-0880
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP030503363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics