Derek Bolalin, CRNP
Nurse Practitioner, Family in Westminster, MD. Individual provider (NPI-1).
NPI number1326735002
StatusActive
Last updated in NPPESJul 23, 2023
Details
- NPI
- 1326735002
- Entity type
- Individual (NPI-1)
- Name
- Derek Bolalin
- Credential
- CRNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 21, 2023
- Certification date
- Jul 23, 2023
- Last updated
- Jul 23, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | R237327 | MD | Yes |
Practice location
826 Washington Rd Ste 110aWestminster, MD 21157-5779
Phone 619-252-1730
Mailing address
826 Washington Rd Ste 110aWestminster, MD 21157-5779
Phone 619-252-1730
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