Individual
SUSAN MARIE BOLLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1002 WISHARD BLVD, INDIANAPOLIS, IN 46202-2872
(317) 944-4846
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71009390A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300030679
—
IN
Enumeration date
09/10/2019
Last updated
10/11/2019
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