Individual
BARBARA A BOLDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
515 N MAIN ST, CARROLL, IA 51401
(712) 792-4000
Mailing address
515 N MAIN ST, CARROLL, IA 51401
(712) 792-4000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000745
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00347793
RR MEDICARE
IA
Enumeration date
07/07/2005
Last updated
06/22/2011
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