Provider Demographics
NPI:1386083962
Name:HOLLISTER, KATHERINE A (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:HOLLISTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 CAMPUS DR
Mailing Address - Street 2:SUITE 12
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5892
Mailing Address - Country:US
Mailing Address - Phone:603-422-8208
Mailing Address - Fax:603-422-8218
Practice Address - Street 1:100 CAMPUS DR
Practice Address - Street 2:SUITE 12
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5892
Practice Address - Country:US
Practice Address - Phone:603-422-8208
Practice Address - Fax:603-422-8218
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH12107207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine