Individual
KELLY A HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22001 JAMAICA AVE, QUEENS VILLAGE, NY 11428-2140
(718) 412-1848
Mailing address
12 BROOKLYN AVE APT 501, VALLEY STREAM, NY 11581-1287
(929) 404-1011
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/08/2020
Last updated
05/15/2025
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