Individual
MELISSA L BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3441 RIDGECREST ROAD EXT # EXD, JACKSON, TN 38305
(731) 988-9119
(731) 660-8739
Mailing address
1804 HIGHWAY 45 BYP STE 604, JACKSON, TN 38305-4403
(731) 660-7971
(731) 660-8739
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13076
TN
363LA2100X
Acute Care Nurse Practitioner
13076
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13076
APN LICENSE
TN
Enumeration date
11/13/2007
Last updated
05/25/2018
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