Provider Demographics
NPI:1811941305
Name:HOLMER, JULIE ETTA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ETTA
Last Name:HOLMER
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 1:202 LAURA LN
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4044
Mailing Address - Country:US
Mailing Address - Phone:850-932-2236
Mailing Address - Fax:
Practice Address - Street 1:1300 SAWGRASS CORPORATE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2826
Practice Address - Country:US
Practice Address - Phone:800-243-3839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-065340363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care