Individual
JO ANN N BOLLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
308 S WASHINGTON ST, CLINTON, KY 42031-1340
(270) 254-3021
(270) 254-3023
Mailing address
627 ASHEVILLE HWY, GREENEVILLE, TN 37743-5401
(423) 626-1521
(423) 626-1523
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
43737
TN
208D00000X
General Practice Physician
43737
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000502868
BCBS
KY
05
—
4046827
—
TN
01
—
4143318
BCBS
TN
Enumeration date
03/16/2006
Last updated
12/27/2016
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