Provider Demographics
NPI:1871206235
Name:HOLLINGSEAD, DUSTIN CHASE (FNP)
Entity type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:CHASE
Last Name:HOLLINGSEAD
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8914 CONEY ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-8800
Mailing Address - Country:US
Mailing Address - Phone:661-426-3575
Mailing Address - Fax:
Practice Address - Street 1:8914 CONEY ISLAND DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-8800
Practice Address - Country:US
Practice Address - Phone:661-426-3575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily