Provider Demographics
NPI:1548296049
Name:BOLLINGER, JANICE MARIE (CNM)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:MARIE
Last Name:BOLLINGER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-2316
Mailing Address - Fax:717-848-5540
Practice Address - Street 1:2050 S QUEEN ST
Practice Address - Street 2:STE 200
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4829
Practice Address - Country:US
Practice Address - Phone:717-812-2316
Practice Address - Fax:717-848-5540
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW008452L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100436OtherGEISINGER
PA145565OtherUNISON-WMG
PA2103636OtherMAMSI-WMG
PA7215897OtherAETNA
PA03008301OtherCAPITAL BLUE CROSS-WMG
PA20019475OtherAMERIHEALTH MERCY
PA32673OtherJOHNS HOPKINS
PA100939197Medicaid
PA20019475OtherAMERIHEALTH MERCY
S47281Medicare UPIN
PA215401FLTMedicare PIN