Provider Demographics
NPI:1952597759
Name:HOLMES, ELIZABETH E (RN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:E
Last Name:HOLMES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N 43RD ST
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-9517
Mailing Address - Country:US
Mailing Address - Phone:505-703-0556
Mailing Address - Fax:
Practice Address - Street 1:601 N 43RD ST
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-9517
Practice Address - Country:US
Practice Address - Phone:505-703-0556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR22491163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMR22491OtherNM STATE NURSING LICENSE