Bolton, Kasey L

Bolton, Kasey L is an individual health care provider with primary practice located at 1250 Jesse Jewell Pkwy Se Ste 200, Gainesville GA 30501-3871. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Bolton, Kasey L can be contacted via phone (770) 297-7277.

Contact Information

Primary practice address
1250 Jesse Jewell Pkwy Se Ste 200 Gainesville GA 30501-3871
Phone: (770) 297-7277
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN134351 Georgia

Profile Details

NPI number 1184754210
LBN Legal business name Bolton, Kasey L
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2007
Last updated Mar 7th, 2022 - about 2 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 1184754210 NPPES
Georgia MEDICAID 377733892A

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