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General NPI Number Information
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NPI Number | 1467613109
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Entity Type | Individual
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Provider Name | AMBER LOUANN BOLYARD CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 01/16/2018
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Provider Practice Location Address
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Address Line | 1115 S WALDRON RD STE 107
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City | FORT SMITH
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State | AR
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Zip | 72903-2584
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Country | US
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Telephone | 479-785-2555
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Fax |
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Provider Business Mailing Address
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Address Line | 7703 FLOYD CURL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3901
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Country | US
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Telephone | 210-358-4000
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R71508
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP126085
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CTP000070
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | C02707
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License Number State | AR
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