Individual
MRS. CRYSTAL ANNE BOLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
6300 22 MILE RD STE 2, SHELBY TOWNSHIP, MI 48317-2106
(586) 726-9860
Mailing address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5111
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021100905
MI
Other
Enumeration date
01/26/2022
Last updated
01/26/2022
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