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Individual

BRYAN A BOLSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
611 W PARK ST, EMERGENCY MEDICINE, URBANA, IL 61801-2529
(217) 383-3311
Mailing address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-6792

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209015927
IL
363LF0000X
Family Nurse Practitioner
209015927
IL

Other

Enumeration date
04/26/2017
Last updated
09/10/2025
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