MEDICARE: MS. HANNAH BOLINGER CRNP

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
1	363LF0000X	Family Nurse Practitioner	R165730	MD

General Provider Information

NPI Number	:	1417460718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HANNAH BOLINGER CRNP

Provider Business Mailing Address
First Line	:	7876 W RIVERSIDE DR
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-3824
Country	:	US
Telephone Number	:	410-701-0289
Fax Number	:

Provider Business Practice Location Address
First Line	:	7876 W RIVERSIDE DR
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-3824
Country	:	US
Telephone Number	:	410-701-0289
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2017
Last Update Date	:	12/16/2025

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