Madison Bolen
Individual provider Active NPI Registered Nurse · Prestonsburg, KY
NPI 1710600648 · NPPES record last updated Sep 26, 2022
Key facts
- NPI
- 1710600648
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 1179640 (KY)
- Practice address
- 104 S Front Ave
Prestonsburg, KY 41653-1614 - Phone
- (606) 886-8572
- Fax
- (606) 886-4433
- NPI assigned
- Sep 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1179640 | KY | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1179640 | KY | Yes |
Addresses
Primary practice location
104 S Front Ave
Prestonsburg, KY 41653-1614
Mailing address
104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572
Other providers in Prestonsburg, KY
- Queenzlynn Boateng
- Brooklyn Boggs
- Candace Boggs
- Kayla Boggs
- Tayler Boggs
- Kendra Boles
- Brittany Bolin
- Nicole Bolling
- Sarah Bolling
- Crystal Bond
All providers in Prestonsburg, KY · Registered Nurse in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2022. 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.