Doctor Name: | MURRITA C. BOLINGER |
NPI Number: | 1013912799 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CFNP |
License Number: | 38386 |
Business Practice Address: | 606 Washington Street Ravenswood, WV - 261641373 |
Business Phone Number: | 3042731033 |
Business Fax Number: | 3042731034 |
Mailing Address: | Po Box 609, ELIZABETH |
State: | WV |
Postal Code: | 261430609 |
Phone Number: | 3042753301 |
Fax Number: | 3042754798 |
NPI Enumeration Date: | 06/17/2005 |
NPI Last Update Date: | 02/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 38386 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |