Doctor Name: | MR. TERRY DEAN HOLLOWELL |
NPI Number: | 1063888329 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP |
License Number: | 95002586 |
Business Practice Address: | 305 E 8th St National City, CA - 919502311 |
Business Phone Number: | 6194770084 |
Business Fax Number: | |
Mailing Address: | 823 Gateway Center Way, SAN DIEGO |
State: | CA |
Postal Code: | 921024541 |
Phone Number: | 6199064623 |
Fax Number: | 6199064564 |
NPI Enumeration Date: | 08/20/2015 |
NPI Last Update Date: | 10/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 95002586 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |