Jacqueline Bolin
Jacqueline Bolin is a Student in an Organized Health Care Education/Training Program in Mesa, Arizona. Practices as a sole proprietor. Registered with an NPI since 2021.
- In the registry since
- 2021
- Specialties on file
- 2
Practice location Address checks out
1157 S Crismon RdMesa, AZ 85208-2661
Phone: (480) 776-3790
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Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1275119521 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | March 18, 2021 |
| Last updated in NPPES | January 10, 2022 |
| Certification date | January 10, 2022 |
| Mailing address | 14247 S 47th Pl, Phoenix, AZ 85044-6206 |
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