Provider Demographics
NPI:1366231490
Name:HOLMES, DANA
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:HOLMES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4217 BRIXTON RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-7763
Mailing Address - Country:US
Mailing Address - Phone:443-449-0703
Mailing Address - Fax:
Practice Address - Street 1:4217 BRIXTON RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-7763
Practice Address - Country:US
Practice Address - Phone:443-449-0703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No172A00000XOther Service ProvidersDriver
No172V00000XOther Service ProvidersCommunity Health Worker