Provider Demographics
NPI:1871390021
Name:HOLDEN, MICHAELA (RN)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:HOLDEN
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 WILLIAMS
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:73057-3679
Mailing Address - Country:US
Mailing Address - Phone:405-756-1414
Mailing Address - Fax:
Practice Address - Street 1:504 WILLIAMS
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:OK
Practice Address - Zip Code:73057-3679
Practice Address - Country:US
Practice Address - Phone:405-756-1414
Practice Address - Fax:405-756-1162
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK208588163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse