Provider Demographics
NPI:1831177898
Name:BOLIN, JUDITH (CRNP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:BOLIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 PRETTY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NUNNELLY
Mailing Address - State:TN
Mailing Address - Zip Code:37137-2911
Mailing Address - Country:US
Mailing Address - Phone:931-729-1656
Mailing Address - Fax:931-729-1654
Practice Address - Street 1:2 INTERNATIONAL DRIVE SUITE 602
Practice Address - Street 2:NP CARE OF TENNESSEE LLC
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217
Practice Address - Country:US
Practice Address - Phone:615-366-1264
Practice Address - Fax:615-361-8632
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN064148363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily