Individual
NANCY ELIZABETH HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8888 LADUE ROAD, SUITE 130, ST. LOUIS, MO 63124
(314) 862-4002
(314) 862-4008
Mailing address
7114 WATERMAN AVE, SAINT LOUIS, MO 63130-4325
(314) 862-4746
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MOR8702
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35787
—
MO
Enumeration date
07/18/2006
Last updated
07/08/2007
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