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General NPI Number Information
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NPI Number | 1083425946
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Entity Type | Individual
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Provider Name | KATHRYN ERICA BOLSTAD FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/18/2025
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 8338 E 21ST ST N
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City | WICHITA
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State | KS
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Zip | 67206-2979
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Country | US
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Telephone | 316-215-8339
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Fax |
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Provider Business Mailing Address
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Address Line | 208 S MAIN ST
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City | HILLSBORO
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State | KS
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Zip | 67063-1514
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Country | US
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Telephone | 620-266-6343
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-83613-111
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License Number State | KS
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