Provider Demographics
NPI:1306689500
Name:BOLYARD, SARAH LEANN (LPN)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:LEANN
Last Name:BOLYARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 VAN VOORHIS RD STE 2
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2737
Mailing Address - Country:US
Mailing Address - Phone:304-598-8900
Mailing Address - Fax:
Practice Address - Street 1:13622 S PRESTON HWY
Practice Address - Street 2:
Practice Address - City:TUNNELTON
Practice Address - State:WV
Practice Address - Zip Code:26444-7156
Practice Address - Country:US
Practice Address - Phone:304-626-5512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-15
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV30151164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse