Healthcare Provider Details

I. General information

NPI: 1316756372
Provider Name (Legal Business Name): LAURA ANNELEISE BOLMEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 SAINT CHARLES CT
CHARLOTTESVILLE VA
22901-4004
US

IV. Provider business mailing address

1117 SAINT CHARLES CT
CHARLOTTESVILLE VA
22901-4004
US

V. Phone/Fax

Practice location:
  • Phone: 434-996-5939
  • Fax:
Mailing address:
  • Phone: 434-996-5939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001306262
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024192701
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: