SHANNON ELOISE BOLT ARNP NPI 1083006522

NPI Information

NPI: 1083006522
Provider Name: SHANNON ELOISE BOLT, ARNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
4209 TIETON DR
YAKIMA, WA
ZIP 98908
Phone: (509) 654-9810
Get Directions

Shannon Eloise Bolt, ARNP is a family nurse practitioner in Yakima, WA with 2 years of experience. Shannon Eloise Bolt, ARNP NPI is 1083006522. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4209 TIETON DR
YAKIMA, WA
ZIP 98908-377
Phone: (509) 654-9810
Fax: (509) 966-8812

The NPI 1083006522 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/20/2015 and was last updated on 11/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		RN60528267	WASHINGTON	No
2	363LF0000X	Nurse Practitioner	Family	AP61369683	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	AP61369683	OTHER	WASHINGTON	WASHINGTON STATE DEPARTMENT OF HEALTH
2	RN60528267	OTHER	WASHINGTON	WASHINGTON STATE DEPARTMENT OF HEALTH
3	F10220605	OTHER		AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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