Healthcare Provider Details

I. General information

NPI: 1013139245
Provider Name (Legal Business Name): HOLLISTER BLAINE ROGERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HOLLY BLAINE ROGERS M.D.

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 IREDELL ST
DURHAM NC
27705-4120
US

IV. Provider business mailing address

503 COMPTON PL
DURHAM NC
27707-2254
US

V. Phone/Fax

Practice location:
  • Phone: 919-999-3935
  • Fax: 919-416-3711
Mailing address:
  • Phone: 919-433-7876
  • Fax: 919-416-3711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9400138
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: