Individual
JULIANNE HOLLIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
55 W WILLOWBROOK DR STE 103, MERIDIAN, ID 83646-3242
(208) 402-9956
Mailing address
55 W WILLOWBROOK DR, STE 103, MERIDIAN, ID 83646-3242
(208) 402-9956
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
63993
ID
363LG0600X
Gerontology Nurse Practitioner
Primary
63993
ID
Other
Enumeration date
03/03/2020
Last updated
04/27/2020
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