Provider Demographics
NPI:1578116224
Name:GUENTHER, HOLLIS DANIEL (MSN FNP)
Entity Type:Individual
Prefix:
First Name:HOLLIS
Middle Name:DANIEL
Last Name:GUENTHER
Suffix:
Gender:M
Credentials:MSN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8208 MONBO RD
Mailing Address - Street 2:
Mailing Address - City:CATAWBA
Mailing Address - State:NC
Mailing Address - Zip Code:28609-9263
Mailing Address - Country:US
Mailing Address - Phone:704-307-1766
Mailing Address - Fax:
Practice Address - Street 1:1601 BRENNER AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2515
Practice Address - Country:US
Practice Address - Phone:704-638-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily