Healthcare Provider Details

I. General information

NPI: 1659365229
Provider Name (Legal Business Name): HELEN-LOUISE BOLING CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 E MAIN CROSS ST
EDINBURGH IN
46124-1501
US

IV. Provider business mailing address

911 E MAIN CROSS ST
EDINBURGH IN
46124-1501
US

V. Phone/Fax

Practice location:
  • Phone: 812-526-9999
  • Fax: 812-526-4900
Mailing address:
  • Phone: 812-526-9999
  • Fax: 812-526-4900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number04619
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number71002941A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: