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NPI Code Detail

MEDICARE: GABRIELLE KIEDREN LOUISE HOLDEN PMHNP

MEDICARE: GABRIELLE KIEDREN LOUISE HOLDEN PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner3018477KY

General Provider Information

NPI Number : 1811613995
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIELLE KIEDREN LOUISE HOLDEN PMHNP
Provider Business Mailing Address
First Line : 1646 PRATHER DR
Second Line :
City : NANCY
State : KY
Zip : 42544-8724
Country : US
Telephone Number : 931-241-8323
Fax Number :
Provider Business Practice Location Address
First Line : 212 N 2ND ST STE 100
Second Line :
City : RICHMOND
State : KY
Zip : 40475-1408
Country : US
Telephone Number : 270-348-3849
Fax Number : 931-342-8386
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2022
Last Update Date : 05/27/2026

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