Individual
REILLY AUTUMN BOLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
302 HUSSON AVE, BANGOR, ME 04401-3374
(207) 947-6141
Mailing address
26 CAPRI ST, BREWER, ME 04412-1337
(207) 570-0848
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
CNP251004
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/16/2024
Last updated
01/03/2025
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