Organization Name: | BOLES HEALTHCARE SERVICES LLC |
NPI Number: | 1215134895 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BOLES E BOLES (OWNER) |
Mailing Address: | 601 Brown St Celina |
State: | TN US |
Postal Code: | 38551 |
Phone Number: | 9312432684 |
Fax Number: | 9312432684 |
NPI Enumeration Date: | 06/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | APN0000006428 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |