Provider Demographics
NPI:1306994165
Name:BOLIN, LINDA (RN, ANP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:BOLIN
Suffix:
Gender:F
Credentials:RN, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1682 WOODFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-9372
Mailing Address - Country:US
Mailing Address - Phone:252-757-3611
Mailing Address - Fax:
Practice Address - Street 1:STUDENT HEALTH SERVICE
Practice Address - Street 2:EAST CAROLINA UNIVERSITY MAIN CAMPUS
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858
Practice Address - Country:US
Practice Address - Phone:252-328-6841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC900137363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care