Provider Demographics
NPI:1114917085
Name:HOLM, KATHARINE (RN, MSN, FNP)
Entity Type:Individual
Prefix:MS
First Name:KATHARINE
Middle Name:
Last Name:HOLM
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636256
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-585-5502
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:2751 O'VARSITY WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45221-1618
Practice Address - Country:US
Practice Address - Phone:513-556-2564
Practice Address - Fax:513-556-1337
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1107655 / 4640P363LF0000X
OHAPRN.CNP.08439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily