Healthcare Provider Details

I. General information

NPI: 1417935040
Provider Name (Legal Business Name): CARRIE JEAN-BOROWSKI BOLLMANN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1249 M-75 SOUTH
BOYNE CITY MI
49712
US

IV. Provider business mailing address

1249 M-75 SOUTH
BOYNE CITY MI
49712
US

V. Phone/Fax

Practice location:
  • Phone: 231-582-1515
  • Fax: 231-582-2425
Mailing address:
  • Phone: 231-582-1515
  • Fax: 231-582-2425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704177269
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: