| NPI | 1790219061 |
|---|---|
| Former Name | KEELYN BOLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 24190) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 198603) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2023-10-23 |