Individual
CYNTHIA D BOLENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1600 WILLOW CREEK RD, PRESCOTT, AZ 86301-1108
(928) 776-7477
(928) 776-0693
Mailing address
2610 E UNIVERSITY DR, MESA, AZ 85213-8436
(480) 892-8400
(480) 892-9533
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
045589
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
836489
—
AZ
Enumeration date
08/07/2006
Last updated
10/19/2010
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