Provider Demographics
NPI:1831809565
Name:BOLYARD, AMY JEANETTE (FNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JEANETTE
Last Name:BOLYARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NEW ORLEANS RD
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-4715
Mailing Address - Country:US
Mailing Address - Phone:843-842-9960
Mailing Address - Fax:
Practice Address - Street 1:30 NEW ORLEANS RD
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-4715
Practice Address - Country:US
Practice Address - Phone:843-842-9960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN.APRN26532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily