Individual
MS. AMANDA M BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-5222
Mailing address
6465 WAYZATA BLVD, STE 315, ST LOUIS PARK, MN 55426-1728
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 144590-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
393079300
—
MN
Enumeration date
03/16/2006
Last updated
03/24/2015
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