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NPI Code Detail

MEDICARE: VICKI L BOLING APRN

MEDICARE: VICKI L BOLING APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerRN12342MT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00086831OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1373530OTHERMTBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1396731287
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI L BOLING APRN
Provider Business Mailing Address
First Line : PO BOX 219
Second Line :
City : BILLINGS
State : MT
Zip : 59103-0219
Country : US
Telephone Number : 406-252-5658
Fax Number : 406-238-3617
Provider Business Practice Location Address
First Line : 1245 N 29TH ST
Second Line :
City : BILLINGS
State : MT
Zip : 59101-0122
Country : US
Telephone Number : 406-252-5658
Fax Number : 406-238-3617
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 02/03/2012

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