SHANNON ELOISE BOLT ARNP NPI 1083006522

NPI Information

  • NPI: 1083006522
  • Provider Name: SHANNON ELOISE BOLT, ARNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4209 TIETON DR
    YAKIMA, WA
    ZIP 98908
  • Phone: (509) 654-9810

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NPI Details

Shannon Eloise Bolt, ARNP is a family nurse practitioner in Yakima, WA with 3 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Melanoma (skin cancer) excision (HCPCS:NAN03)

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
1163W00000XRegistered NurseRN60528267WASHINGTONNo
2363LF0000XNurse PractitionerFamilyAP61369683WASHINGTONYes

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
1AP61369683OTHERWASHINGTONWASHINGTON STATE DEPARTMENT OF HEALTH
2RN60528267OTHERWASHINGTONWASHINGTON STATE DEPARTMENT OF HEALTH
3F10220605OTHERAMERICAN 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: 3/30/2025

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