Individual
MS. EMILY REBECCA BOLLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4610 KANAWHA AVE SW STE 200, SOUTH CHARLESTON, WV 25309-1367
(304) 205-7992
Mailing address
4610 KANAWHA AVE SW STE 200, SOUTH CHARLESTON, WV 25309-1367
(304) 205-7992
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1147
WV
363AM0700X
Medical Physician Assistant
Primary
1147
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1147
WV LICENSE
WV
Enumeration date
07/13/2006
Last updated
03/03/2026
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