Bolf, Kelly Marie

Bolf, Kelly Marie is an individual health care provider with primary practice located at 400 E 3Rd St , Duluth MN 55805-1951. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bolf, Kelly Marie can be contacted via phone (218) 786-8364.

Contact Information

Primary practice address
400 E 3Rd St Duluth MN 55805-1951
Phone: (218) 786-8364
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R1345942 Minnesota

Profile Details

NPI number 1629004247
LBN Legal business name Bolf, Kelly Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2006
Last updated Apr 29th, 2011 - about 13 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 1629004247 NPPES
Minnesota MEDICAID 599190100

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