Provider Demographics
NPI:1831707470
Name:HOLMES, REBECCA GAY (NP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:GAY
Last Name:HOLMES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:985-730-6970
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:617 AVENUE F
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3637
Practice Address - Country:US
Practice Address - Phone:985-545-1070
Practice Address - Fax:985-545-1071
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA229102363LF0000X
MS904031207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine