Provider Demographics
NPI:1982445607
Name:HOLDHEIDE, KAREN JEAN (APRN-CNM)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:JEAN
Last Name:HOLDHEIDE
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:892 E KREMER HOYING RD
Mailing Address - Street 2:
Mailing Address - City:SAINT HENRY
Mailing Address - State:OH
Mailing Address - Zip Code:45883-9787
Mailing Address - Country:US
Mailing Address - Phone:419-733-8152
Mailing Address - Fax:
Practice Address - Street 1:10228 DUPONT CIRCLE DR E STE 100
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1611
Practice Address - Country:US
Practice Address - Phone:200-222-7401
Practice Address - Fax:260-209-5956
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH0019620367A00000X
IN09000471C367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife