Individual
DENNISE M HOLLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 4TH AVE, HUNTINGTON, WV 25701-1219
(304) 525-5691
Mailing address
135 4TH AVE, HUNTINGTON, WV 25701-1219
(304) 525-5691
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
36692
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36692
LPN
WV
Enumeration date
05/07/2021
Last updated
05/07/2021
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