Provider Demographics
NPI:1235481250
Name:BOLL-PRICE, NANCY ANN (APNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANN
Last Name:BOLL-PRICE
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:PULMONARY DISEASE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-955-7040
Mailing Address - Fax:414-955-6211
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:PULMONARY DISEASE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-955-7040
Practice Address - Fax:414-955-6211
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5097-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1235481250Medicaid
WI736012603Medicare PIN
WI1235481250Medicaid