Healthcare Provider Details

I. General information

NPI: 1417655721
Provider Name (Legal Business Name): HOLLIE M CAPPO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LEW DEWITT BLVD STE B
WAYNESBORO VA
22980-1663
US

IV. Provider business mailing address

PO BOX 388
FISHERSVILLE VA
22939-0388
US

V. Phone/Fax

Practice location:
  • Phone: 540-245-7950
  • Fax: 540-245-7951
Mailing address:
  • Phone: 540-932-5275
  • Fax: 540-932-5875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024186551
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: