Provider Demographics
NPI:1366179095
Name:BOLES, KAREEM (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:KAREEM
Middle Name:
Last Name:BOLES
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1947 FAHEY DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-7093
Mailing Address - Country:US
Mailing Address - Phone:919-999-7156
Mailing Address - Fax:
Practice Address - Street 1:1101 MARCO DR STE 200
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-2540
Practice Address - Country:US
Practice Address - Phone:919-636-5240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016737363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health