Individual
MRS. JACQUELYN BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
34TH STREET & CIVIC CENTER BOULEVARD, PHILADELPHIA, PA 19104
(215) 590-3084
Mailing address
83 DEER HORN DR, MOUNT ROYAL, NJ 08061-1089
(571) 439-5119
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
SP012733
PA
Other
Enumeration date
03/22/2013
Last updated
01/23/2015
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