Individual
CHARLOTTE JANIS BLISSETT HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
5201 HARRY HINES BLVD, WISH TUBAL CLINIC, DALLAS, TX 75235-7708
(214) 590-5306
(214) 590-2798
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
234536
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041510102
—
TX
05
—
041510103
—
TX
05
—
041510104
—
TX
05
—
041510105
—
TX
05
—
041510106
—
TX
05
—
041510107
—
TX
05
—
041510108
—
TX
05
—
041510109
—
TX
05
—
041510110
—
TX
05
—
041510111
—
TX
05
—
041510112
—
TX
01
—
8Y5450
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/29/2006
Last updated
05/18/2009
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