Individual
MARY CAY BOLSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
311 W FAIRCHILD ST, DANVILLE, IL 61832-3876
(217) 431-7898
(217) 554-1750
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3311
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-000358
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE9335
RR GROUP
IL
01
—
P00393307
RR MEDICARE NUMBER
IL
Enumeration date
07/30/2006
Last updated
03/19/2018
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