| NPI | 1164967246 |
|---|---|
| Former Name | ASHLEY LEINANI BOLAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 844096-01) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60862230) |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2024-01-18 |