Healthcare Provider Details

I. General information

NPI: 1881519080
Provider Name (Legal Business Name): EARL BOLLINGER NNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4946 SUMMA CT
BATON ROUGE LA
70809-3702
US

IV. Provider business mailing address

4946 SUMMA CT
BATON ROUGE LA
70809-3702
US

V. Phone/Fax

Practice location:
  • Phone: 985-373-8025
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAP01181
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: