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Individual

MRS. REBECCA LYNN BOLLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2620 E BARNETT RD, SUITE H, MEDFORD, OR 97504-8344
(541) 789-4281
(541) 789-2558
Mailing address
560 CATALINA DR, ASHLAND, OR 97520-1605
(541) 201-4930
(541) 201-4931

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200850001NP
OR
363LF0000X
Family Nurse Practitioner
327
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022868
OR
01
13995
STATE LICENSE
AK
01
20850001NP
OREGON LICENSE
OR
01
327
STATE LICENSE
AK
Enumeration date
10/05/2007
Last updated
02/12/2016
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