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KIRSTEN TORI BOLSTAD PA
>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1407402266
Individual Registrant: KIRSTEN TORI BOLSTAD PA
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1012 BELMONT AVE # 81050 LA JUNTA, CO 81050-2101 US
Tel: 719-383-5900 Fax: --
Tel: 719-383-5900 Fax: --
Contact information for business:
1012 BELMONT AVE LA JUNTA, CO 81050-2101 US
Tel: 608-606-2547 Fax: --
Tel: 608-606-2547 Fax: --
Registration Information:
NPI: 1407402266
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | CO | PA.0005890 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
