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General NPI Number Information
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NPI Number | 1679191902
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Entity Type | Individual
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Provider Name | JAMIE LYNN BOLE CNP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 4650 HILLS AND DALES RD NW STE 200
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City | CANTON
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State | OH
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Zip | 44708-6221
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Country | US
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Telephone | 330-491-9675
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Fax |
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Provider Business Mailing Address
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Address Line | 4650 HILLS AND DALES RD NW STE 200
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City | CANTON
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State | OH
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Zip | 44708-6221
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Country | US
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Telephone |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN-CNP0027428
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License Number State | OH
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