Provider Demographics
NPI:1427682822
Name:BOLEY, JENNA RENEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:RENEE
Last Name:BOLEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 A AVENUE NE
Mailing Address - Street 2:PO BOX 3080
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52406-3080
Mailing Address - Country:US
Mailing Address - Phone:319-391-5501
Mailing Address - Fax:319-743-2610
Practice Address - Street 1:855 A AVE NE STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5064
Practice Address - Country:US
Practice Address - Phone:319-391-5501
Practice Address - Fax:319-743-2610
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA158037363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily