Individual
MR. RUDOLPH HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA LIC SW
Contact information
Practice address
2301 THOMAS AVE N, MINNEAPOLIS, MN 55411-2355
(612) 251-5738
Mailing address
2301 THOMAS AVE N, MINNEAPOLIS, MN 55411-2355
(612) 251-5738
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8534
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113136
HEALTHPARTNERS OF MN
MN
01
—
3G739HO
BLUE CROSS BLUE SHIELD MN
MN
01
—
8534
STATE LICENSE
MN
Enumeration date
03/12/2007
Last updated
07/09/2007
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