Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 0389442304 | NH |
NPI | 1033166491 |
---|---|
Provider Name | Susan M Hollinger |
First Address | Durham, NH 03824-4500 |
Second Address | Derry, NH 03038-2136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S87615 | (02) | NH |