Provider Demographics
NPI:1215323662
Name:BOLAND, ERIN (RN,APN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BOLAND
Suffix:
Gender:F
Credentials:RN,APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 95000 LB#7550
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-7550
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:508 HAMBURG TPKE STE 202
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-8482
Practice Address - Country:US
Practice Address - Phone:973-956-1404
Practice Address - Fax:973-956-1646
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2022-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00561700363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner