Individual
MRS. GIANNA BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5 STATE ST, TULLY, NY 13159-3273
(315) 696-4635
Mailing address
16 TYLER CT, MANLIUS, NY 13104-1741
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F351074-01
NY
Other
Enumeration date
02/28/2023
Last updated
03/11/2024
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