Organization
JOMON WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY BOLLER NP (OWNER/NP)
(859) 287-2949
Entity
Organization
Contact information
Practice address
132 FRONTIER BLVD STE 103, STANFORD, KY 40484-6516
(859) 287-2949
(855) 297-6367
Mailing address
132 FRONTIER BLVD STE 103, STANFORD, KY 40484-6516
(859) 287-2949
(855) 297-6367
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/23/2024
Last updated
11/20/2025
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