Provider Demographics
NPI:1013574524
Name:BOLGER, ERIN ANNE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ANNE
Last Name:BOLGER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 YORK ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2423
Mailing Address - Country:US
Mailing Address - Phone:617-721-7079
Mailing Address - Fax:
Practice Address - Street 1:529 MAIN ST STE 222
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-1101
Practice Address - Country:US
Practice Address - Phone:617-426-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN266942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily