Healthcare Provider Details

I. General information

NPI: 1811613995
Provider Name (Legal Business Name): GABRIELLE KIEDREN LOUISE HOLDEN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 N 2ND ST STE 100
RICHMOND KY
40475-1408
US

IV. Provider business mailing address

1646 PRATHER DR
NANCY KY
42544-8724
US

V. Phone/Fax

Practice location:
  • Phone: 270-348-3849
  • Fax: 931-342-8386
Mailing address:
  • Phone: 931-241-8323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3018477
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: