Individual
JODIE ANN BOLLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
601 COMMONWEALTH DR, NORTON, VA 24273-4053
(276) 679-6028
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024185268
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024185268
LICENSE NUMBER
VA
Enumeration date
09/15/2022
Last updated
11/09/2023
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