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General NPI Number Information
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NPI Number | 1679629018
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Entity Type | Individual
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Provider Name | NANCY MARIE HOLLISTER NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 11/23/2025
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Provider Practice Location Address
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Address Line | 24100 AMADOR ST
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City | HAYWARD
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State | CA
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Zip | 94544-1273
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Country | US
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Telephone | 510-567-5704
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Fax |
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Provider Business Mailing Address
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Address Line | 5736 MEDALLION CT
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City | CASTRO VALLEY
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State | CA
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Zip | 94552-1708
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Country | US
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Telephone | 510-889-7074
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Fax | 510-889-7074
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 190436
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License Number State | CA
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