Individual
PAIGE BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3101 SE 14TH ST, BENTONVILLE, AR 72712
(479) 986-6090
Mailing address
3101 SE 14TH ST, BENTONVILLE, AR 72712-4900
(479) 986-6090
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R098054
AR
363LF0000X
Family Nurse Practitioner
Primary
A005666
AR
Other
Enumeration date
05/09/2018
Last updated
06/06/2018
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