NPI 1003198029

Marcia Angela Bolles, PAC

Practitioner Physician Assistant Madison, WI

Practice location

Address: 5249 E Terrace Dr, Madison, WI 53718-8339
Phone: (608) 222-9777
Fax: (608) 221-2646
Mailing address: 7954 W Oakbrook Cir, Madison, WI 53717-1676

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 2804-023 (WI)

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Registry record

NPI: 1003198029
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Sep 2011
Record last updated: 15 Sep 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.