Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 0103000695 | VA |
Y | 222Z00000X | Podiatrist | 0103000695 | VA |
N | 213E00000X | Podiatrist | P0474 | DC |
N | 222Z00000X | Podiatrist | P0474 | DC |
N | 213EP0504X | Public Medicine | 0103000695 | VA |
N | 213EP0504X | Public Medicine | P0474 | DC |
N | 213EP1101X | Primary Podiatric Medicine | 0103000695 | VA |
N | 213EP1101X | Primary Podiatric Medicine | P0474 | DC |
N | 111NR0200X | Radiology | 0103000695 | VA |
N | 213ER0200X | Radiology | 0103000695 | VA |
N | 111NR0200X | Radiology | P0474 | DC |
N | 213ER0200X | Radiology | P0474 | DC |
N | 2081S0010X | Sports Medicine | 0103000695 | VA |
N | 213ES0000X | Sports Medicine | 0103000695 | VA |
N | 2081S0010X | Sports Medicine | P0474 | DC |
N | 213ES0000X | Sports Medicine | P0474 | DC |
N | 213ES0131X | Foot Surgery | 0103000695 | VA |
N | 213ES0131X | Foot Surgery | P0474 | DC |
NPI | 1003908898 |
---|---|
Provider Name | Dr. Edna C Holmes |
First Address | Woodbridge, VA 22191-3016 |
Second Address | Woodbridge, VA 22191-3016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 20/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00Y336HO1 | INDIVIUAL PTAN (01) | VA |
026083 | PODIATRY (01) | VA |
5407 | PODIATRY (01) | DC |
9302409 | (05) | VA |
T21620 | (02) | VA |