Provider Demographics
NPI:1306085733
Name:HOLMON, VALERIAH ANN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:VALERIAH
Middle Name:ANN
Last Name:HOLMON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:VALERIAH
Other - Middle Name:ANN
Other - Last Name:HOLMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:4450 FASHION SQUARE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1251
Mailing Address - Country:US
Mailing Address - Phone:989-792-4090
Mailing Address - Fax:989-792-4094
Practice Address - Street 1:4450 FASHION SQUARE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-1251
Practice Address - Country:US
Practice Address - Phone:989-792-4090
Practice Address - Fax:989-792-4094
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704183088363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner