Jacquelyn Boland, NNP-BC

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

SP012733 Issued in PA

Practice address

34TH Street & Civic Center Boulevard
Philadelphia, PA 19104

Phone

(215) 590-3084

NPI assigned

Mar 22, 2013

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": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1376885897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 DEER HORN DR",
            "city": "MOUNT ROYAL",
            "state": "NJ",
            "postal_code": "080611089",
            "telephone_number": "571-439-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34TH STREET & CIVIC CENTER BOULEVARD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-590-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "JACQUELYN",
        "name_prefix": "Mrs.",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "PA",
            "license": "SP012733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia A Boken, MD
• Vickrum Bokinkere
• Caitlin Boland, R.D., L.D.N
• Daniel Boland, M.D.
• Emily Boland, LCSW
• Carol Bolanos, D.M.D.
• Oladayo Bolarinwa, MD
• Jake Bolden Jr., M.S. CFC, CJAS.
• Cassandra Renee Bolding, LPC
• Patricia Boldt

• Neonatal Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Neonatal Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.