Provider Demographics
NPI:1316756372
Name:BOLMEY, LAURA ANNELEISE (NP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNELEISE
Last Name:BOLMEY
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 SAINT CHARLES CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-4004
Mailing Address - Country:US
Mailing Address - Phone:434-996-5939
Mailing Address - Fax:
Practice Address - Street 1:1117 SAINT CHARLES CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-4004
Practice Address - Country:US
Practice Address - Phone:434-996-5939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-04
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001306262163W00000X
VA0024192701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse