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Individual

LAUREN E BOLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
1 CHILDRENS WAY # 512-3, LITTLE ROCK, AR 72202-3500
(501) 364-1479
(501) 364-3667
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-5148

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1031
AR
363A00000X
Physician Assistant
PA06131
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202531401
TX
Enumeration date
05/06/2009
Last updated
08/02/2023
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