Provider Demographics
NPI:1447084900
Name:HOLMEN, KATERINA ROSE
Entity type:Individual
Prefix:
First Name:KATERINA
Middle Name:ROSE
Last Name:HOLMEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:POWERS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58773-0306
Mailing Address - Country:US
Mailing Address - Phone:701-641-2720
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 306
Practice Address - Street 2:
Practice Address - City:POWERS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58773-0306
Practice Address - Country:US
Practice Address - Phone:701-641-2720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant