Individual
KELLY BOLERJACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
2500 W WILLIAM CANNON DR STE 503, AUSTIN, TX 78745-5286
(512) 243-8066
Mailing address
2500 W WILLIAM CANNON DR STE 503, AUSTIN, TX 78745-5286
(512) 243-8066
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
99623
TX
Other
Enumeration date
03/20/2019
Last updated
12/12/2025
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