Individual
GINA BOLTON FARLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5895 KATHERINE ST, SOUTHSIDE, AL 35907-0005
(256) 490-9304
Mailing address
5895 KATHERINE ST, SOUTHSIDE, AL 35907-0005
(256) 490-9304
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-122037
AL
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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