Individual
SARA BOLEYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
251 COUNTY ROAD 120, SAINT CLOUD, MN 56303-4872
(320) 202-8949
(320) 202-0756
Mailing address
251 COUNTY ROAD 120, SAINT CLOUD, MN 56303-4872
(320) 202-8949
(320) 202-0756
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R1365870
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
701104100
—
MN
Enumeration date
06/28/2006
Last updated
02/17/2016
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