Provider Demographics
NPI:1659231322
Name:HOLM, RACHEL SUE (LPN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:SUE
Last Name:HOLM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 MILITARY BLVD
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-2451
Mailing Address - Country:US
Mailing Address - Phone:563-387-5840
Mailing Address - Fax:563-387-5841
Practice Address - Street 1:1106 MILITARY BLVD
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-2451
Practice Address - Country:US
Practice Address - Phone:563-387-5840
Practice Address - Fax:563-387-5841
Is Sole Proprietor?:No
Enumeration Date:2025-11-14
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAP44268164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse