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Individual

CAROLYN FAIRCLOTH HOLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.R.N.P.

Contact information

Practice address
24980 STATE ST, PO DRAWER 519, ELBERTA, AL 36530-2573
(251) 986-7301
(251) 986-5927
Mailing address
24980 STATE ST, PO DRAWER 519, ELBERTA, AL 36530-2573
(251) 986-7301
(251) 986-5927

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1023686
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00051740
AL
01
51051740
BCBS-AL
AL
01
P00289187
RAILROAD MEDICARE
AL
Enumeration date
01/20/2006
Last updated
02/20/2020
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