Individual
CRISTINA SMITH BOLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP APRNC
Contact information
Practice address
9880 ANGIES WAY, SUITE 420, LOUISVILLE, KY 40241-2851
(502) 629-5400
(502) 629-5492
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
24728
TN
363LF0000X
Family Nurse Practitioner
Primary
3011085
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001074358
ANTHEM
KY
01
—
226541
SIHO
KY
01
—
50125255
PASSPORT
KY
05
—
7100471030
—
KY
01
—
K218100
MEDICARE
KY
Enumeration date
02/13/2017
Last updated
04/04/2019
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