Jennifer Lynn Bollmann, LPN

Individual provider Active NPI Licensed Practical Nurse · Selden, NY

NPI 1104250299 · NPPES record last updated Aug 26, 2013

Key facts

NPI
1104250299
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
315534 (NY)
Practice address
533 College Rd
Selden, NY 11784-2851
Phone
(571) 594-0956
NPI assigned
Aug 26, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
315534NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 315534 NY Yes

Addresses

Primary practice location

533 College Rd
Selden, NY 11784-2851

Mailing address

75 Mayfield Dr
Mastic Beach, NY 11951-1726
Phone (571) 594-0956

Other providers in Selden, NY

All providers in Selden, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.