Provider Demographics
NPI:1881736767
Name:HOLMES, JENNIFER E (BSN)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:E
Last Name:HOLMES
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 LORNA RD STE 110
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4500
Mailing Address - Country:US
Mailing Address - Phone:205-824-2418
Mailing Address - Fax:
Practice Address - Street 1:3021 LORNA RD STE 110
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-4500
Practice Address - Country:US
Practice Address - Phone:205-824-2418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-044780163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse