LUCY BOLERJACK DO NPI 1346815875

NPI Information

  • NPI: 1346815875
  • Provider Name: LUCY BOLERJACK, DO
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 836 PRUDENTIAL DR STE 1202
    JACKSONVILLE, FL
    ZIP 32207
  • Phone: (904) 493-5323

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NPI Details

Lucy Bolerjack, DO is an obstetrics gynecology in Jacksonville, FL with 5 years of experience. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Lucy Bolerjack, DO NPI is 1346815875. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduation Year:2021

The provider's business location address is:

836 PRUDENTIAL DR STE 1202
JACKSONVILLE, FL
ZIP 32207-339
Phone: (904) 493-5323
Fax: (866) 554-1605

The NPI 1346815875 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 5/26/2021 and was last updated on 7/11/2025.

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
1207V00000XObstetrics & Gynecology5151014839MICHIGANNo
2207V00000XObstetrics & GynecologyOS22431FLORIDAYes

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: 11/21/2025

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