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Individual

JENNIFER BOLIN GOULD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
10628 PARK RD, ANESTHESIA SERVICES, CHARLOTTE, NC 28210-8407
(704) 667-1970
(704) 667-1684
Mailing address
4400 GOLF ACRES DR, STE A, CHARLOTTE, NC 28208-5906
(704) 512-6428

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
238403
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8054354
NC
05
NAN153
SC
Enumeration date
01/17/2013
Last updated
04/21/2017
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