Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacqueline Bolin

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1275119521

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 Rd
Mesa, AZ 85208-2661
Phone: (480) 776-3790
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1275119521
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 18, 2021
Last updated in NPPESJanuary 10, 2022
Certification dateJanuary 10, 2022
Mailing address14247 S 47th Pl, Phoenix, AZ 85044-6206

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