Healthcare Provider Details

I. General information

NPI: 1114954864
Provider Name (Legal Business Name): CYNTHIA L HOLLORAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 SWIFTWATER RD SUITE 2
WOODSVILLE NH
03785-1447
US

IV. Provider business mailing address

79 SWIFTWATER RD SUITE 2
WOODSVILLE NH
03785-1447
US

V. Phone/Fax

Practice location:
  • Phone: 603-747-2900
  • Fax: 603-747-2992
Mailing address:
  • Phone: 603-747-2900
  • Fax: 603-747-2992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0291632305
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: