Individual
MARKEYSHA RENA HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2607 LEDO RD, ALBANY, GA 31707-1211
(229) 903-0022
Mailing address
2607 LEDO RD, ALBANY, GA 31707-1211
(229) 903-0022
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN091032
GA
183700000X
Pharmacy Technician
PHTC007718
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056095298
—
GA
Enumeration date
12/15/2017
Last updated
12/15/2017
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