Healthcare Provider Details

I. General information

NPI: 1538601968
Provider Name (Legal Business Name): JENNIFER ANN BOLEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2016
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6582 165TH ST
ALBIA IA
52531-8793
US

IV. Provider business mailing address

6582 165TH ST
ALBIA IA
52531-8793
US

V. Phone/Fax

Practice location:
  • Phone: 641-932-7172
  • Fax: 641-932-7174
Mailing address:
  • Phone: 641-932-7172
  • Fax: 641-932-7174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA128889
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberA128889
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: