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Individual

ASHLEY CHARLTON BOLTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
529 S JACKSON ST, LOUISVILLE, KY 40202-3229
(502) 562-4369
Mailing address
350 S DORSEY LN, LOUISVILLE, KY 40223-3574
(502) 321-8070

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3010591
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201404300
IN
05
7100444480
KY
Enumeration date
09/08/2016
Last updated
11/17/2017
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