Individual
JACOB HOLLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
116 S 1ST ST UNIT 1, MADISON, WI 53704-5212
(262) 490-6458
Mailing address
116 S 1ST ST UNIT 1, MADISON, WI 53704-5212
(262) 490-6458
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
249439-30
WI
Other
Enumeration date
10/13/2025
Last updated
10/13/2025
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