Individual
KASEY L BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1250 JESSE JEWELL PKWY SE, STE 200, GAINESVILLE, GA 30501-3871
(770) 297-7277
Mailing address
200 S ENOTA DR NE, SUITE 150, GAINESVILLE, GA 30501-3473
(770) 534-5255
(770) 287-3871
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN134351
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377733892A
—
GA
Enumeration date
03/07/2007
Last updated
03/07/2022
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