Bolanger, Krista D

Bolanger, Krista D is an individual health care provider with primary practice located at 9000 N Main St Suite 227, Dayton OH 45415-1180. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Bolanger, Krista D can be contacted via phone (937) 832-4773.

Contact Information

Primary practice address
9000 N Main St Suite 227 Dayton OH 45415-1180
Phone: (937) 832-4773
Fax: (937) 832-2986
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 50 002179 Ohio

Profile Details

NPI number 1073651337
LBN Legal business name Bolanger, Krista D
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2007
Last updated Oct 23rd, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073651337 NPPES
Ohio MEDICAID 0067813

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