Chanda Quinn Holmes, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Selma, TX
NPI 1811228356 · NPPES record last updated Jan 25, 2024
Key facts
- NPI
- 1811228356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 1143403 (TX)
- Practice address
- 3509 Treeline Acres
Selma, TX 78154-1964 - Phone
- (916) 206-1772
- NPI assigned
- Jan 22, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240424000782 | TX | Practitioner - Nurse Practitioner | 7618316696 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 708318 | TX | MD | Registered Nurse |
| 1143403 | TX | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 708318 | TX | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1143403 | TX | Yes |
Addresses
Primary practice location
3509 Treeline Acres
Selma, TX 78154-1964
Mailing address
3509 Treeline Acres
Selma, TX 78154-1964
Phone (916) 206-1772
Other providers in Selma, TX
- Miguel Angel Garcia
- Monica Aguilera Garfias
- Loren M Gorman
- Thomas Leo Hamilton
- Alexandra Higgins
- Patricia L. Horton
- Tara Howard
- Yatika Jain
- Maurice Jones
- LBF Speech Communication Consulting Services
All providers in Selma, TX · Psychiatric/Mental Health Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.