Provider Demographics
NPI:1043595267
Name:BOLES, HANNA M (RN)
Entity Type:Individual
Prefix:MRS
First Name:HANNA
Middle Name:M
Last Name:BOLES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 GUFFEY ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TN
Mailing Address - Zip Code:38551-4089
Mailing Address - Country:US
Mailing Address - Phone:931-243-2651
Mailing Address - Fax:931-243-3132
Practice Address - Street 1:115 GUFFEY ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TN
Practice Address - Zip Code:38551-4089
Practice Address - Country:US
Practice Address - Phone:931-243-2651
Practice Address - Fax:931-243-3132
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000177791163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health