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Individual

MS. CAROL DIANE BOLINGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
100 N MEDICAL DR, SALT LAKE CITY, UT 84113-1103
(801) 662-2992
Mailing address
945 ECHO LN, PARK CITY, UT 84098-5727
(435) 649-3550

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2741534405
UT
363LP0200X
Pediatric Nurse Practitioner
Primary
2741534405
UT

Other

Enumeration date
01/01/2008
Last updated
01/01/2008
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