Individual
JENE BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
818 N CARRIAGE PKWY, WICHITA, KS 67208-4500
(316) 651-2216
(316) 651-2256
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9667
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1392045082
KS
363LF0000X
Family Nurse Practitioner
Primary
5375693082
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201100240D
—
KS
Enumeration date
11/28/2012
Last updated
07/21/2022
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