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1184605743
THERESA M BOLEY
SPRINGFIELD, IL
NPI
1184605743
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209000839)
Enumeration Date
2005-11-10
Last Update Date
2012-10-24
Business Address
-- THERESA M BOLEY CFNP
315 W CARPENTER ST 2ND FLOOR
SPRINGFIELD, IL 62702-4901
Phone number: 217-545-7422
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Mailing Address
-- THERESA M BOLEY CFNP
PO BOX 19638
SPRINGFIELD, IL 62794-9638
Phone number: 217-545-7422
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