Kimiko Chanee Bolden

Individual provider Active NPI Case Management Registered Nurse · Pooler, GA

NPI 1114837580 · NPPES record last updated Sep 9, 2026

Key facts

NPI
1114837580
Entity type
Individual (NPI type 1)
Primary specialty
Case Management Registered Nurse 163WC0400X
License
RN305914 (GA)
Practice address
508 S Rogers St
Pooler, GA 31322-3116
Phone
(912) 748-6840
NPI assigned
Sep 9, 2026
Sex
Female
Sole proprietor
No

Medicare participation

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X RN305914 GA Yes

Addresses

Primary practice location

508 S Rogers St
Pooler, GA 31322-3116

Mailing address

601 Quacco Rd Unit 3804
Savannah, GA 31419-9912
Phone (912) 390-1148

Other providers in Pooler, GA

All providers in Pooler, GA · Case Management Registered Nurse in Georgia

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2026. Information in NPPES is self-reported and not verified by CMS.
  • NUCC Health Care Provider Taxonomy: specialty names.

Verify at the official NPI Registry.