Individual
MS. VICTORIA HOLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,ANP
Contact information
Practice address
3009 N BALLAS RD, SUITE 102B, SAINT LOUIS, MO 63131-2322
(314) 725-2010
(314) 725-0709
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(314) 725-2010
(314) 725-0709
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
121611
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
121611
MO
363LF0000X
Family Nurse Practitioner
121611
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952495046
—
MO
05
—
425299336
—
MO
Enumeration date
10/03/2006
Last updated
08/08/2016
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