Individual
ELLEN BOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-4598
Mailing address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-4598
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R192924
MD
Other
Enumeration date
03/10/2016
Last updated
03/10/2016
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