Provider Demographics
NPI:1942866553
Name:HOLMQUEST, BAILEY ROSE (RD, LD, CLT)
Entity type:Individual
Prefix:MISS
First Name:BAILEY
Middle Name:ROSE
Last Name:HOLMQUEST
Suffix:
Gender:F
Credentials:RD, LD, CLT
Other - Prefix:MISS
Other - First Name:BAILEY
Other - Middle Name:ROSE
Other - Last Name:HALVERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDN,LRD
Mailing Address - Street 1:1220 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-5633
Mailing Address - Country:US
Mailing Address - Phone:701-741-4069
Mailing Address - Fax:701-540-0422
Practice Address - Street 1:1220 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-5633
Practice Address - Country:US
Practice Address - Phone:701-741-4069
Practice Address - Fax:701-540-0422
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1188133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered