Individual
JENNIFER E BOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
36586
AZ
2086S0122X
Plastic and Reconstructive Surgery Physician
47854
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020910400
—
MN
Enumeration date
01/20/2006
Last updated
03/23/2018
Update your record
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