Active NPI
Brianna Nicole Bolter
- Student in an Organized Health Care Education/Training Program
- Traverse City, MI
National Provider Identifier
1578908786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 990 Garfield Woods Dr Ste B
Traverse City, MI 49686-5160 - Phone
- (231) 668-4909
- NPI assigned
- May 1, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
990 Garfield Woods Dr Ste B
Traverse City, MI 49686-5160
Mailing address
10924 Cedar Hedge TRL
Interlochen, MI 49643-9708
Phone (231) 715-8908
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367366400000",
"number": "1578908786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10924 CEDAR HEDGE TRL",
"city": "INTERLOCHEN",
"state": "MI",
"postal_code": "496439708",
"telephone_number": "231-715-8908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 GARFIELD WOODS DR STE B",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496865160",
"telephone_number": "231-668-4909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLTER",
"first_name": "BRIANNA",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-01",
"last_updated": "2013-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.