Individual
HOLLY LEE WHITESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
286 S 16TH ST, GROVER BEACH, CA 93433-2245
(805) 473-7040
Mailing address
286 S 16TH ST, GROVER BEACH, CA 93433-2245
(805) 473-7040
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
95053005
CA
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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