MS. KAITLIN JACKLENE HOLCOMB NP-C NPI 1902205818

NPI Information

NPI: 1902205818
Provider Name: MS. KAITLIN JACKLENE HOLCOMB, NP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2799 W GRAND BLVD
DETROIT, MI
ZIP 48202
Phone: (586) 615-7769
Get Directions

MS. Kaitlin Jacklene Holcomb, NP-C is a family nurse practitioner in Detroit, MI with 10 years of experience. MS. Kaitlin Jacklene Holcomb, NP-C NPI is 1902205818. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2799 W GRAND BLVD
DETROIT, MI
ZIP 48202-608
Phone: (586) 615-7769

The NPI 1902205818 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/15/2014 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	209.011658	ILLINOIS	No
2	363LF0000X	Nurse Practitioner	Family	4704285017	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1902205818	MEDICAID	MICHIGAN
2	4704285017	OTHER	MICHIGAN	RN AND APN LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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