Melissa Lynn Bolster, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

318725-1 Issued in NY

Practice address

2155 Ny-22B
Morrisonville, NY 12962

Phone

(518) 563-8000

NPI assigned

Mar 14, 2019

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

Other identifiers 1

Electronic endpoints 1

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": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1922567486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 LAVALLEY RD",
            "city": "CHAMPLAIN",
            "state": "NY",
            "postal_code": "129194600",
            "telephone_number": "518-521-8712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 NY-22B",
            "city": "MORRISONVILLE",
            "state": "NY",
            "postal_code": "12962",
            "telephone_number": "518-563-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLSTER",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "318725-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318725-1",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "trelation@bhsn.org",
            "affiliation": "N",
            "address_1": "2155 NY-22B",
            "city": "Morrisonville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "12962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Brittany Lynn Bennett, LPN
• Michele Bogensberger, LMHC
• Shannon Marie Bond
• Michael Lee Bowen
• Corey Edward Boyd, RN
• Heather Lynn Bradley, LCSW
• Sara Lynn Broadwell, PHYSICAL THERAPIST

• Licensed Practical Nurse in Morrisonville, NY
• Providers in Morrisonville, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; 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.