Individual
KRISTA A BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
109 INDEPENDENCE LN STE 200, LA FOLLETTE, TN 37766-3034
(423) 562-4968
(423) 562-5603
Mailing address
PO BOX 440545, NASHVILLE, TN 37244-0545
(865) 670-6199
(865) 670-6198
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25039
TN
Other
Enumeration date
11/09/2018
Last updated
11/09/2018
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