Doctor Name: | MS. MICHELLE LYNN BOLTZ |
NPI Number: | 1194843870 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 957 |
Business Practice Address: | 214 E 3rd St Libby, MT - 599232056 |
Business Phone Number: | 4062939274 |
Business Fax Number: | 4062939280 |
Mailing Address: | 214 E 3rd St, LIBBY |
State: | MT |
Postal Code: | 599232056 |
Phone Number: | 4062939274 |
Fax Number: | 4062939280 |
NPI Enumeration Date: | 03/27/2007 |
NPI Last Update Date: | 04/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 957 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |