Individual
GENIE A BOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3316 HIGHWAY 280, ALEXANDER CITY, AL 35010-3369
(256) 329-7120
(256) 329-7600
Mailing address
1452 RIVER OAKS DR, JACKSONS GAP, AL 36861-3126
(256) 825-0338
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1046766
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51035245
BLUE CROSS PROVIDER NUMBE
AL
Enumeration date
07/21/2006
Last updated
07/09/2007
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