Individual
DR. KERILYN BOLLMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11250 N TATUM BLVD STE 103, PHOENIX, AZ 85028-2306
(480) 460-8485
(480) 504-0520
Mailing address
11250 N TATUM BLVD STE 103, PHOENIX, AZ 85028-2306
(480) 460-8485
(480) 504-0520
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25919
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
457673
—
AZ
Enumeration date
04/25/2006
Last updated
06/11/2019
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