Most Relevant Information
Provider Data
| NPI Number: | 1003470402 |
| Provider Name: | MITCHELL BOLES APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | RN233677 |
Most Important Dates
| Enumeration Date: | 05/01/2019 |
| Last Updated: | 02/15/2022 |
Provider Practice Location
1665 HIGHWAY 34 E STE 100
NEWNAN
GA
302652404
Practice Location Phone/Fax
| Phone: | 7702527557 |
| Fax: | 7702527513 |
Provider Mailing Location
1665 HIGHWAY 34 E STE 100
NEWNAN
GA
302652404
Provider Mailing Phone/Fax
| Phone: | 7702527557 |
| Fax: |