Provider Demographics
NPI:1649971748
Name:BOLLIG, SABRINA INGRID (DNP)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:INGRID
Last Name:BOLLIG
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2357 108TH LN NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-5222
Mailing Address - Country:US
Mailing Address - Phone:763-780-0776
Mailing Address - Fax:
Practice Address - Street 1:2357 108TH LN NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-5222
Practice Address - Country:US
Practice Address - Phone:763-780-0776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9755363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily