Provider Demographics
NPI:1427001155
Name:HOLLAND, KRISTEN E (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:E
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:PEDIATRIC DERMATOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-1569
Mailing Address - Fax:414-266-3315
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC DERMATOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-1569
Practice Address - Fax:414-266-3315
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI45289207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
008906261XOtherHUMANA
WI1427001155Medicaid
WI1427001155Medicaid
WI320640160Medicare PIN
WI736011950Medicare PIN