Kimberly Bolen, FNP
Individual provider Active NPI Family Nurse Practitioner · Beaver, WV
NPI 1457782179 · NPPES record last updated Jun 22, 2016
Key facts
- NPI
- 1457782179
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN64281-FNP-BC (WV)
- Practice address
- 856 Ritter Dr
Beaver, WV 25813-9513 - Phone
- (304) 255-4845
- NPI assigned
- Dec 5, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN64281-FNP-BC | WV | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M I Dababnah MD Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN64281-FNP-BC | WV | Yes |
Addresses
Primary practice location
856 Ritter Dr
Beaver, WV 25813-9513
Mailing address
PO Box 663
Cool Ridge, WV 25825-0663
Phone (304) 222-0479
Other names
- Ms. Kim Bolen
Other providers in Beaver, WV
- Beckley Treatment Center, LLC
- Shannon Bell
- Amanda Marie Berry
- Brent A Blair
- Joseph Blevins
- Krista Bowling
- Jill A Boyce
- Lauren Boyd
- Tiziana Rae Bradley
- Shaelyn Braenovich
All providers in Beaver, WV · Family Nurse Practitioner in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.