Provider Demographics
NPI:1063698793
Name:BOLLINGER, ANN M (RN)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:BOLLINGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20346 ENNIS RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-4108
Mailing Address - Country:US
Mailing Address - Phone:302-856-1926
Mailing Address - Fax:302-856-1950
Practice Address - Street 1:48 CHURCH ST
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:DE
Practice Address - Zip Code:19933-1034
Practice Address - Country:US
Practice Address - Phone:302-337-3469
Practice Address - Fax:302-337-6016
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0028638163W00000X
261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service