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Individual

MS. AMY KATHERINE BOLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
8219 LEESBURG PIKE STE 100, VIENNA, VA 22182-2625
(301) 873-7508
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9359225
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008968900
FL
Enumeration date
04/19/2013
Last updated
06/13/2022
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