Doctor Name: | RENE HOLMES |
NPI Number: | 1366815680 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 19857 |
Business Practice Address: | 7300 Georgia Hwy 21 Port Wentworth, GA - 314079205 |
Business Phone Number: | 8663892727 |
Business Fax Number: | |
Mailing Address: | 5 Star Magnolia Ct, LADYS ISLAND |
State: | SC |
Postal Code: | 299072582 |
Phone Number: | 8435824621 |
Fax Number: | |
NPI Enumeration Date: | 11/09/2015 |
NPI Last Update Date: | 05/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 19857 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |