Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 1-089564 | AL |
NPI | 1083058473 |
---|---|
Provider Name | Courtney Harrell Holmes |
First Address | Birmingham, AL 35249-1900 |
Second Address | Birmingham, AL 35249-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2013 |
Last Update Date | 29/04/2013 |