Provider Demographics
NPI:1063849131
Name:HOLMDEN, CAROL ANN (NP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:HOLMDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:5022 RIFLE RIVER TRL
Mailing Address - Street 2:
Mailing Address - City:ALGER
Mailing Address - State:MI
Mailing Address - Zip Code:48610-9327
Mailing Address - Country:US
Mailing Address - Phone:989-873-1571
Mailing Address - Fax:989-873-1574
Practice Address - Street 1:81 S I 75 BUSINESS LOOP
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-7405
Practice Address - Country:US
Practice Address - Phone:989-348-7400
Practice Address - Fax:888-821-5005
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2021-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704147309363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner