Provider Demographics
NPI:1659365229
Name:BOLING, HELEN-LOUISE (CPNP)
Entity Type:Individual
Prefix:
First Name:HELEN-LOUISE
Middle Name:
Last Name:BOLING
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 E MAIN CROSS ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:46124-1501
Mailing Address - Country:US
Mailing Address - Phone:812-526-9999
Mailing Address - Fax:812-526-4900
Practice Address - Street 1:911 E MAIN CROSS ST
Practice Address - Street 2:
Practice Address - City:EDINBURGH
Practice Address - State:IN
Practice Address - Zip Code:46124-1501
Practice Address - Country:US
Practice Address - Phone:812-526-9999
Practice Address - Fax:812-526-4900
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04619363L00000X
IN71002941A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201028860Medicaid
OH2178469Medicaid
OH000000 319389OtherANTHEM
MI4207109Medicaid
OH80439Medicare UPIN
MI4207109Medicaid
OH500007755Medicare PIN