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LISA BOLLES LPN
>> Licensed Practical Nurse >> Nursing Service ProvidersRegistrant NPI Number: 1013315357
Individual Registrant: LISA BOLLES LPN
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
210 THIRD ST NEWPORT, AR 72112-3302 US
Tel: 870-524-9496 Fax: --
Tel: 870-524-9496 Fax: --
Contact information for business:
PO BOX 1589 BENTON, AR 72018-1589 US
Tel: 501-315-3344 Fax: --
Tel: 501-315-3344 Fax: --
Registration Information:
NPI: 1013315357
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 164W00000X | Nursing Service Providers Licensed Practical Nurse | AR | L041134 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
