Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. ANITA BOULOM, PA-C
ActiveMRS. ANITA BOULOM, PA-C is a Physician Assistant healthcare provider located in JANESVILLE, Wisconsin. NPI 1184213555 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · JANESVILLE, WI
Registration Details
- NPI Number
- 1184213555
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 11, 2021 (5.5779933340015 yrs)
- Last Updated
- Jan 11, 2021
- License
-
5192-23 (WI)
Practice Information
- Address
-
3400 DEERFIELD DRJANESVILLE, WI, 535463557Browse WI providers · Browse ZIP 53546
- Phone
- 6083143600
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in JANESVILLE, WI
| Name | Credential | NPI |
|---|---|---|
| ADRIENNE JONES ELERT | PA-C | 1578527297 |
| CHRISTOPHER B GOODAVISH | PA | 1043275720 |
| DEBRA L MILLS | PA-C | 1245288596 |
| MICHELLE B ESCH | PA-C | 1073611265 |
| KATHERINE D. KETTERHAGEN | PA-C | 1356414668 |
| LYNN M JOHNSTON | PA-C | 1346313483 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.