Basic Information
| Provider Information | |||||||||
| NPI: | 1134480460 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOLMES | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | GIFFORD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 N SHADELAND AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462194959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3179623834 | ||||||||
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| Practice Location | |||||||||
| Address1: | 355 W 16TH STREET | ||||||||
| Address2: | ADULT PSYCHIATRY OUTPATIENT CLINIC | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462022207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3179637300 | ||||||||
| FaxNumber: | 9199669646 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2012 | ||||||||
| LastUpdateDate: | 01/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 182365 | NC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2084P0800X | 01078129A | IN | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.