Individual provider Active NPI

Anmarie Holden

  • Licensed Practical Nurse
  • Herrin, IL
National Provider Identifier
1780823955
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
043.102295 Issued in IL
Practice address
609 S 14TH St
Herrin, IL 62948-3805
Phone
(618) 218-8103
NPI assigned
Feb 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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 043.102295 IL Primary

Addresses

Primary practice location

609 S 14TH St
Herrin, IL 62948-3805

Mailing address

609 S 14TH St
Herrin, IL 62948-3805
Phone (618) 218-8103

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
043.102295ILMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234310400000",
    "number": "1780823955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 S 14TH ST",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483805",
            "telephone_number": "618-218-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 S 14TH ST",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483805",
            "telephone_number": "618-218-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "ANMARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043.102295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.