MRS. SHANNON KRISTINE BOLES ACNP NPI 1760552665

NPI Information

MRS. Shannon Kristine Boles, ACNP is an acute care nurse practitioner in Saint Louis, MO with 19 years of experience. MRS. Shannon Kristine Boles, ACNP NPI is 1760552665. 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:

4901 FOREST PARK AVE
DIV SURG ACCS, STE 340
SAINT LOUIS, MO
ZIP 63108-495
Phone: (314) 362-5298
Fax: (314) 362-5743

The NPI 1760552665 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 11/8/2006 and was last updated on 11/15/2021.

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:

Other Identifiers

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

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