Provider Demographics
NPI:1780421107
Name:HOLBROOK, CARRIE
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5327 E GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ALGER
Mailing Address - State:MI
Mailing Address - Zip Code:48610-9302
Mailing Address - Country:US
Mailing Address - Phone:989-873-0238
Mailing Address - Fax:
Practice Address - Street 1:5327 E GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:ALGER
Practice Address - State:MI
Practice Address - Zip Code:48610-9302
Practice Address - Country:US
Practice Address - Phone:989-873-0238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide