Iva Jean Bolman, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

003859 Issued in SD

Practice address

601 Gall St.
Lower Brule, SD 57548

Phone

(605) 473-0852

NPI assigned

Oct 24, 2007

Last updated

Oct 24, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1336328574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 18",
            "address_2": "RR 8 HC5",
            "city": "RELIANCE",
            "state": "SD",
            "postal_code": "57369",
            "telephone_number": "605-473-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GALL ST.",
            "city": "LOWER BRULE",
            "state": "SD",
            "postal_code": "57548",
            "telephone_number": "605-473-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLMAN",
        "first_name": "IVA",
        "middle_name": "JEAN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-24",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SD",
            "license": "003859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse A Abernathy, CSW
• Sayyem Hussain Akbar, PHARM.D
• Tessah Renee Bien, CNP
• Roberta Jo Ducheneaux-Sinclair, RN
• Ellen Durkin
• Helen H. Grant, M.D.
• Steve Gray, PHARM D, RPH
• Indian Health Services

• Licensed Practical Nurse in Lower Brule, SD
• Providers in Lower Brule, SD by specialty
• Licensed Practical Nurse in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.