Active NPI
Sequoia Sana' Holmes
- Licensed Vocational Nurse
- Tyler, TX
National Provider Identifier
1124643507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 352301
- Practice address
- 3326 S SW Loop 323
Tyler, TX 75701-9237 - Phone
- (903) 617-1502
- Fax
- (903) 630-1074
- NPI assigned
- Jun 11, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 352301 | TX | Primary |
Addresses
Primary practice location
3326 S SW Loop 323
Tyler, TX 75701-9237
Mailing address
3326 S SW Loop 323
Tyler, TX 75701-9237
Phone (903) 617-1502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 352301 | TX | MD | Licensed Vocational Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| God's Handiwork LLC | Current | Accepting new patients |
Locations
3326 S Southwest Loop 323
Tyler, TX 75701
Phone (903) 617-1502
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708560000000",
"number": "1124643507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3326 S SW LOOP 323",
"city": "TYLER",
"state": "TX",
"postal_code": "757019237",
"telephone_number": "903-617-1502",
"fax_number": "903-630-1074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3326 S SW LOOP 323",
"city": "TYLER",
"state": "TX",
"postal_code": "757019237",
"telephone_number": "903-617-1502",
"fax_number": "903-630-1074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "SEQUOIA",
"middle_name": "SANA'",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-11",
"last_updated": "2024-02-22",
"certification_date": "2024-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "TX",
"license": "352301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.