Individual
KELLY K BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9614 OLD JOHNNYCAKE RIDGE RD, CONCORD TOWNSHIP, OH 44060-6521
(440) 205-1225
Mailing address
PO BOX 381468, GERMANTOWN, TN 38183-1468
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
048765
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.04981
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2181491
—
OH
Enumeration date
02/13/2006
Last updated
02/19/2026
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