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General NPI Number Information
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NPI Number | 1790224699
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Entity Type | Individual
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Provider Name | CRISTINA SMITH BOLIN DNP APRNC
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Gender | Female
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 04/04/2019
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Provider Practice Location Address
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Address Line | 9880 ANGIES WAY SUITE 420
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City | LOUISVILLE
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State | KY
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Zip | 40241-2851
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Country | US
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Telephone | 502-629-5400
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Fax | 502-629-5492
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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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 | 3011085
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 24728
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License Number State | TN
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