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General NPI Number Information
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NPI Number | 1306779590
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Entity Type | Individual
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Provider Name | ANNA DE BOLT P.A.
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Gender | Female
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Dates
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Enumeration Date | 06/05/2026
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Last Update Date | 06/05/2026
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Provider Practice Location Address
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Address Line | 82 UINTA WAY APT 301
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City | DENVER
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State | CO
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Zip | 80230-7329
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Country | US
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Telephone | 808-256-7950
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Fax |
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Provider Business Mailing Address
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Address Line | 82 UINTA WAY APT 301
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City | DENVER
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State | CO
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Zip | 80230-7329
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Country | US
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Telephone | 808-256-7950
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2755-P.A.
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2755-P.A.
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 24-537
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 2755-P.A.
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License Number State | PR
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | TPPA1135
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | S.A.0003415
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License Number State | CO
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