Provider Demographics
NPI:1629382213
Name:HOLMES, AMIE ELIZABETH (MD)
Entity type:Individual
Prefix:MRS
First Name:AMIE
Middle Name:ELIZABETH
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMIE
Other - Middle Name:ELIZABETH
Other - Last Name:HUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:P.O. BOX 28946
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729
Mailing Address - Country:US
Mailing Address - Phone:559-228-4425
Mailing Address - Fax:559-228-4424
Practice Address - Street 1:275 W. HERNDON AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612
Practice Address - Country:US
Practice Address - Phone:559-324-3833
Practice Address - Fax:559-324-3834
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA129969207V00000X
PAMD439115207V00000X
NE27570207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25-1754199OtherVANTAGE
NE47-0675561-13Medicaid
PA225672Medicare PIN