Individual
MRS. TARA LYNN BOLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, NNP-BC
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-7165
Mailing address
506 HUNTING BOW LN, DUNCAN, SC 29334-8403
(864) 504-0046
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
APN.24394
SC
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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