Individual provider · Type 1 NPI
Mary Kathleen Bolles, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Austin, TX
NPI number
1124037957
Active
Practice location
3705 Medical Parkway, #450, Austin Medical Plaza
Austin, TX 78705
Fax (512) 306-0069
Mailing address
3705 Medical Parkway #450, Austin Medical Plaza
Austin, TX 78705
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 13337 (TX) |
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | 521247 (TX) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 521247 (TX) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1124037957
Mary Kathleen Bolles, PMHNP's National Provider Identifier is 1124037957, issued on Aug 8, 2006. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Austin, TX. The record was last updated on Oct 28, 2015.