Provider Demographics
NPI:1649881814
Name:BOLARIN, MONISOLA I (BSN)
Entity type:Individual
Prefix:MRS
First Name:MONISOLA
Middle Name:I
Last Name:BOLARIN
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16838 GLEN CT
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46062-6841
Mailing Address - Country:US
Mailing Address - Phone:317-331-3827
Mailing Address - Fax:219-464-4401
Practice Address - Street 1:16838 GLEN CT
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46062-6841
Practice Address - Country:US
Practice Address - Phone:317-331-3827
Practice Address - Fax:219-464-4401
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28175433A163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management