Provider Demographics
NPI:1427120534
Name:HOLLIWELL, LIZZIE MAE (RN)
Entity type:Individual
Prefix:MS
First Name:LIZZIE
Middle Name:MAE
Last Name:HOLLIWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:LIZZIE
Other - Middle Name:MAE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2535 16TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3417
Mailing Address - Country:US
Mailing Address - Phone:661-634-1000
Mailing Address - Fax:661-634-1040
Practice Address - Street 1:2535 16TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3417
Practice Address - Country:US
Practice Address - Phone:661-634-1000
Practice Address - Fax:661-634-1040
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA505076163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse