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NPI Code Detail

MEDICARE: SARAH ELIZABETH HOLLIS FNP

MEDICARE:   SARAH ELIZABETH HOLLIS  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerCOA.16750-NPOH

General Provider Information

NPI Number : 1720483324
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ELIZABETH HOLLIS FNP
Provider Business Mailing Address
First Line : 107 SPRING BROOK CT
Second Line :
City : ETNA
State : OH
Zip : 43062-8058
Country : US
Telephone Number : 740-815-6815
Fax Number :
Provider Business Practice Location Address
First Line : 1100 HILL RD N
Second Line :
City : PICKERINGTON
State : OH
Zip : 43147-8659
Country : US
Telephone Number : 614-866-7076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2014
Last Update Date : 10/27/2014

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Directions to “ SARAH ELIZABETH HOLLIS FNP” Practice Location

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