Provider Demographics
NPI:1538702337
Name:HOLDEN, KATHY L (NP)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:L
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 E CECIL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:MD
Mailing Address - Zip Code:21901-4012
Mailing Address - Country:US
Mailing Address - Phone:410-287-3727
Mailing Address - Fax:410-287-2819
Practice Address - Street 1:126A E HIGH ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5638
Practice Address - Country:US
Practice Address - Phone:410-398-8300
Practice Address - Fax:410-398-8469
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR165091363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care