Provider Demographics
NPI:1629685219
Name:BOLISAY, ELA KRISTEL OLAN (MSN, APRN-C)
Entity Type:Individual
Prefix:
First Name:ELA KRISTEL
Middle Name:OLAN
Last Name:BOLISAY
Suffix:
Gender:F
Credentials:MSN, APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35380
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5380
Mailing Address - Country:US
Mailing Address - Phone:702-877-5199
Mailing Address - Fax:702-947-5703
Practice Address - Street 1:2845 SIENA HEIGHTS DR STE 2100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4163
Practice Address - Country:US
Practice Address - Phone:702-877-5088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV832093363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily