Individual
LATONYA HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7002 HODGSON MEMORIAL DR STE 113, SAVANNAH, GA 31406-2586
(912) 272-4267
Mailing address
1355 BRADLEY BLVD APT 709, SAVANNAH, GA 31419-8160
(912) 272-4267
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN064789
GA
247ZC0005X
Clinical Laboratory Director (Non-physician)
—
—
251E00000X
Home Health Agency
LPN064789
GA
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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