Provider Demographics
NPI:1124692553
Name:HOLDEN, KATHLEEN MEREDITH (MSN, PMHNP-BC, ARNP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MEREDITH
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC, ARNP
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:MEREDITH
Other - Last Name:THEDENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4240 PARK GLEN RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5427
Mailing Address - Country:US
Mailing Address - Phone:612-925-6033
Mailing Address - Fax:612-925-8496
Practice Address - Street 1:1155 FORD RD STE B
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-1115
Practice Address - Country:US
Practice Address - Phone:952-378-1800
Practice Address - Fax:952-378-1714
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2536446163W00000X
IA132004163W00000X
IAG163773363LP0808X
MN12901363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse