Individual
REBECCA HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
(812) 353-6821
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003201A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201009570
—
IN
Enumeration date
10/13/2009
Last updated
02/02/2021
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