Provider Demographics
NPI:1053904136
Name:HOLMAN, JAMI LEE
Entity type:Individual
Prefix:
First Name:JAMI
Middle Name:LEE
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:LAMBERTON
Mailing Address - State:MN
Mailing Address - Zip Code:56152-1130
Mailing Address - Country:US
Mailing Address - Phone:507-822-8035
Mailing Address - Fax:
Practice Address - Street 1:701 S BIRCH ST
Practice Address - Street 2:
Practice Address - City:LAMBERTON
Practice Address - State:MN
Practice Address - Zip Code:56152-1130
Practice Address - Country:US
Practice Address - Phone:507-822-8035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant