Individual provider Active NPI

Nedra Holbrook, LPN

  • Licensed Practical Nurse
  • Bear, DE
National Provider Identifier
1245067339
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
L2-0013585 Issued in DE
Practice address
726 Fox Chase Cir
Bear, DE 19701-2705
Phone
(302) 580-6208
NPI assigned
Sep 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L2-0013585 DE Primary

Addresses

Primary practice location

726 Fox Chase Cir
Bear, DE 19701-2705

Mailing address

726 Fox Chase Cir
Bear, DE 19701-2705
Phone (302) 580-6208

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

LicenseStateTypeSpecialty
L2-0013585DEMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1245067339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 FOX CHASE CIR",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197012705",
            "telephone_number": "302-580-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 FOX CHASE CIR",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197012705",
            "telephone_number": "302-580-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "NEDRA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "DE",
            "license": "L2-0013585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bear, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.

Verify at the official NPI Registry.