Bolyard, Amber Louann
Bolyard, Amber Louann is an individual health care provider with primary practice located at 1115 S Waldron Rd Ste 107 , Fort Smith AR 72903-2584. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Bolyard, Amber Louann can be contacted via phone (479) 785-2555.Contact Information
Primary practice address
1115 S Waldron Rd Ste 107
Fort Smith AR 72903-2584
Phone: (479) 785-2555
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | R71508 | Arkansas |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | AP126085 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | CTP000070 | Arkansas |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | C02707 | Arkansas |
Profile Details
| NPI number | 1467613109 |
|---|---|
| LBN Legal business name | Bolyard, Amber Louann |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2008 |
| Last updated | Jan 16th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467613109 | NPPES |
| Arkansas | Other | P00628610 | RR MEDICARE GROUP CG8899 |
| Arkansas | MEDICAID | 171992001 | RR MEDICARE GROUP CG8899 |
| Arkansas | MEDICAID | 340737101 | RR MEDICARE GROUP CG8899 |
| Arkansas | Other | P00872567 | RR MEDICARE GROUP CG8899 |
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