Individual
JUDITH A BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
205 NORTH EAST AVENUE, JACKSON, MI 49201-1753
(517) 788-4963
Mailing address
2950 W DELHI RD, ANN ARBOR, MI 48103-9010
(734) 769-4809
(734) 769-4809
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704075734
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018136
CRNA AANA
—
Enumeration date
11/14/2006
Last updated
11/19/2007
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