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General NPI Number Information
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NPI Number | 1497772966
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Entity Type | Individual
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Provider Name | KATHLEEN M BOLGER MS APRN BC
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2410 WALLEY ROAD
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City | FRANKLIN
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State | NY
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Zip | 13775
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Country | US
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Telephone | 607-829-3704
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Fax | 607-829-2117
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Provider Business Mailing Address
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Address Line | PO BOX 225 C/O HOMEBASE BILLING
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City | WEST ONEONTA
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State | NY
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Zip | 13861
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Country | US
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Telephone | 607-263-5987
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Fax | 607-263-5987
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN4923691
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NPPF4007351
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License Number State | NY
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