Healthcare Provider Details

I. General information

NPI: 1487619250
Provider Name (Legal Business Name): KRISTEN L HOLLAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 OLD MINNESOTA AVE
SAINT PETER MN
56082-1763
US

IV. Provider business mailing address

PO BOX 8674
MANKATO MN
56002-8674
US

V. Phone/Fax

Practice location:
  • Phone: 507-625-1811
  • Fax:
Mailing address:
  • Phone: 507-625-1811
  • Fax: 507-625-4754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4346
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number53028
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20794
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: