Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP30007181 | WA |
NPI | 1013009273 |
---|---|
Provider Name | Elizabeth M. Holmes |
First Address | Mount Vernon, WA 98273 |
Second Address | Mount Vernon, WA 98274-6703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 19/02/2020 |