Provider Demographics
NPI:1881738169
Name:BOLLING, AMY K (NP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:K
Last Name:BOLLING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21890
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4115
Mailing Address - Country:US
Mailing Address - Phone:502-907-0356
Mailing Address - Fax:502-919-9780
Practice Address - Street 1:255 CHURCH ST STE 101
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3476
Practice Address - Country:US
Practice Address - Phone:606-260-8613
Practice Address - Fax:859-977-2683
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3011219363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000001537988OtherANTHEM
VA30016137140001Medicaid
KYCS2128800207OtherCARESOURCE
WV1881738169Medicaid
KY7100452010Medicaid