Provider Demographics
NPI:1447389812
Name:BOLAND, ALAYNE N (ARNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ALAYNE
Middle Name:N
Last Name:BOLAND
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1861 PENINSULAR DR
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-8547
Mailing Address - Country:US
Mailing Address - Phone:863-419-1794
Mailing Address - Fax:
Practice Address - Street 1:111 WEBB DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-3944
Practice Address - Country:US
Practice Address - Phone:863-421-9447
Practice Address - Fax:863-421-1806
Is Sole Proprietor?:No
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3395382363LF0000X
ME050824363LF0000X
NYF330186-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily