| NPI | 1790205896 |
|---|---|
| Professional Name | NICOLE KRISTIN LAWRENCE BOLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: IL 043.120833) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2017-06-21 |