Provider Demographics
NPI:1669419735
Name:BOLTON, SHARON (CRNA)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:BOLTON
Suffix:
Gender:F
Credentials:CRNA
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 160
Mailing Address - Street 2:PATIENT FINANCIAL SERVICES
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561
Mailing Address - Country:US
Mailing Address - Phone:603-259-7627
Mailing Address - Fax:603-259-7561
Practice Address - Street 1:600 ST. JOHNSBURY RD.
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561
Practice Address - Country:US
Practice Address - Phone:603-444-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH029981-23-11367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT49997OtherBLUE CROSS BLUE SHIELD
NH541412OtherCIGNA HEALTH CARE
NH4009198Y0NH01OtherBLUE CROSS BLUE SHIELD
VTORE6343Medicaid
NHP37902OtherHARVARD PILGRIM HEALTHCAR
NH80300008Medicaid
NHP37902Medicare UPIN
VTORE6343Medicaid