Provider Demographics
NPI:1093742785
Name:BOLTEN, JUDY A (RN)
Entity Type:Individual
Prefix:PROF
First Name:JUDY
Middle Name:A
Last Name:BOLTEN
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:PSC 817 BOX 32
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09622
Mailing Address - Country:IT
Mailing Address - Phone:39081-568-5973
Mailing Address - Fax:081-568-5976
Practice Address - Street 1:P'SC 827 BOX 1000
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09617
Practice Address - Country:IT
Practice Address - Phone:39081-568-6303
Practice Address - Fax:39081-568-5976
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX520414163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health