Healthcare Provider Details

I. General information

NPI: 1831177898
Provider Name (Legal Business Name): JUDITH BOLIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 INTERNATIONAL DRIVE SUITE 602 NP CARE OF TENNESSEE LLC
NASHVILLE TN
37217
US

IV. Provider business mailing address

2651 PRETTY CREEK RD
NUNNELLY TN
37137-2911
US

V. Phone/Fax

Practice location:
  • Phone: 615-366-1264
  • Fax: 615-361-8632
Mailing address:
  • Phone: 931-729-1656
  • Fax: 931-729-1654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number064148
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: