Marci Bolla, NREMT-P
Individual provider Active NPI Paramedic · Fort Rucker, AL
NPI 1922470012 · NPPES record last updated Oct 28, 2015
Key facts
- NPI
- 1922470012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Paramedic 146L00000X
- License
- M0902987 (AL)
- Practice address
- Building 301 Andrews Ave
Lyster Army Health Clinic
Fort Rucker, AL 36362-5333 - Phone
- (334) 255-7850
- NPI assigned
- Oct 28, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 9700485 | AL | MD | Paramedic |
| M0902987 | AL | MD | Paramedic |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Paramedic | 146L00000X | M0902987 | AL | Yes |
| Paramedic | 146L00000X | 9700485 | AL |
Addresses
Primary practice location
Building 301 Andrews Ave
Lyster Army Health Clinic
Fort Rucker, AL 36362-5333
Mailing address
Builing 301 Andrews Ave
Lyster Army Health Clinic
Fort Rucker, AL 36362-5333
Phone (334) 255-7850
Other providers in Fort Rucker, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2015. 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.