Individual
KEVIN PALMER BOLLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSED LP
Contact information
Practice address
520 NW 5TH ST, BRAINERD, MN 56401-2902
(218) 829-3235
(218) 829-1368
Mailing address
520 NW 5TH ST, BRAINERD, MN 56401-2902
(218) 829-3235
(218) 829-1368
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0335
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121238
UCARE
MN
01
—
386G3BO
BCBSMN
MN
01
—
62-50723
MEDICA UBH
MN
05
—
672053600
—
MN
01
—
990991045425
BHP PREFERRED 1
MN
01
—
HP55897
HEALTH PARTNERS
MN
Enumeration date
04/10/2007
Last updated
12/03/2024
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