Individual
ELIZABETH A HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-BC
Contact information
Practice address
314 NE 19TH AVE, PORTLAND, OR 97232-2829
(415) 999-2792
Mailing address
2623 9TH AVE, OAKLAND, CA 94606-2127
(415) 999-2792
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
10018561
OR
163W00000X
Registered Nurse
95192567
CA
363L00000X
Nurse Practitioner
Primary
10018561
OR
363L00000X
Nurse Practitioner
NP95028849
CA
Other
Enumeration date
07/22/2024
Last updated
07/27/2024
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