Boland, Bobby D.
Boland, Bobby D. is an sole proprietor health care provider with primary practice located at 402 Recovery Rd , Kennett MO 63857-3235. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Boland, Bobby D. can be contacted via phone (573) 888-0274.Contact Information
Primary practice address
402 Recovery Rd
Kennett MO 63857-3235
Phone: (573) 888-0274
Fax: (573) 888-1225
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 152914 | Missouri |
Profile Details
| NPI number | 1699917559 |
|---|---|
| LBN Legal business name | Boland, Bobby D. |
| Credentials | AFNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 24th, 2009 |
| Last updated | Mar 24th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699917559 | NPPES |
| Missouri | Other | 152914 | STATE LISCENCE |
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