| Doctor Name: | MRS. BETTENA BOLTON |
| NPI Number: | 1073879995 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 16193 |
| Business Practice Address: | 3901 Central Pike Ste 259 Hermitage, TN - 37076 |
| Business Phone Number: | 6157308015 |
| Business Fax Number: | 6155950265 |
| Mailing Address: | 131 Saundersville Road, Ste 160 HENDERSONVILLE |
| State: | TN |
| Postal Code: | 37075 |
| Phone Number: | 6157915470 |
| Fax Number: | 6155950265 |
| NPI Enumeration Date: | 04/04/2012 |
| NPI Last Update Date: | 02/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 16193 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |