Provider Demographics
NPI:1467175760
Name:HOLMES, CHELSEA LAUREN (MSN, APRN)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LAUREN
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MSN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7751 BELFORT PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6951
Mailing Address - Country:US
Mailing Address - Phone:904-363-7453
Mailing Address - Fax:
Practice Address - Street 1:725 SKYMARKS DR STE 10-1
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-7296
Practice Address - Country:US
Practice Address - Phone:904-367-2611
Practice Address - Fax:904-367-2670
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11022314363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner