VICKIE BOLL (NPI# 1396737706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396737706 |
| Entity Type | Individual |
| Full Name | VICKIE BOLL |
| Credential | PA-C |
| Practice Address |
4804 W Clearwater Ave Kennewick WA 99336-2119 |
| Mailing Address |
560 Gage Blvd Suite 203 Richland WA 99352-8650 |
| Practice Telephone | 5099422355 |
| Practice Fax Number | 5092221289 |
| Mailing Telephone | 5099423627 |
| Mailing Fax Number | 5099422268 |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2017-01-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA60168389 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA1392 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA338 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD MCCAMMON | 000010161109 | 01 |
| ID | 807226500 | 05 | |
| ID | BLUE SHIELD-AM FALLS | 000010152182 | 01 |
| NV | 1396737706 | 05 | |
| ID | BLUE CROSS-MCCAMMON | PAE62 | 01 |
| ID | BLUE CROSS-LAVA | PANG1 | 01 |
| ID | BLUE CROSS-AM FALLS | PAND8 | 01 |
| ID | BLUE CROSS-DOWNEY | PANE5 | 01 |
| ID | BLUE CROSS-ABERDEEN | PANF3 | 01 |
| WA | 2054118 | 05 | |
| ID | BLUE SHIELD-LAVA | 000010152180 | 01 |
| NV | MEDICARE PTAN | HB721Z | 01 |
| ID | BLUE SHIELD-DOWNEY | 000010152179 | 01 |
| ID | BLUE SHIELD-POCATELLO | 000010152181 | 01 |
| ID | BLUE CROSS-POCATELLO | PANH9 | 01 |
| Street Address |
4804 W CLEARWATER AVE |
| City | KENNEWICK |
| State | WA |
| Zip Code | 99336-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043767122 | Mindy Barber | Nurse Practitioner | 4804 W Clearwater Ave, Kennewick, WA 99336 | 2016-09-06 |
| 1205233400 | Joshua Hughes | Family Medicine | 4804 W Clearwater Ave, Kennewick, WA 99336 | 2014-12-03 |
| 1053654913 | Paul A Shoemaker | Registered Nurse | 4804 W Clearwater Ave, Kennewick, WA 99336-2119 | 2013-03-28 |
| 1649542838 | Laura J Campos | Licensed Practical Nurse | 4804 W Clearwater Ave, Kennewick, WA 99336 | 2012-02-02 |
| 1528391372 | Amanda D Petersen | Physician Assistant | 4804 W Clearwater Ave, Kadlec Clinic Urgent Care, Kennewick, WA 99336 | 2009-09-11 |
| 1982657938 | Franklin C Newhouse | Family Medicine | 4804 W Clearwater Ave, Kennewick, WA 99336-2119 | 2006-05-19 |
| 1841277340 | Bevan W Briggs | Nurse Practitioner | 4804 W Clearwater Ave, Kennewick, WA 99336-2119 | 2005-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497393888 | Kelsie D Parvinen | Massage Therapist | 8350 W. Grandridge Blvd, Suite 100, Kennewick, WA 99336 | 2019-12-16 |
| 1508403858 | New U Women's Clinic & Aesthetics Pllc | Nurse Practitioner | 35 S Louisiana St, Suite A120, Kennewick, WA 99336 | 2019-12-05 |
| 1457901944 | Solar Mobility LLC | Durable Medical Equipment & Medical Supplies | 949 S Keller St, Kennewick, WA 99336 | 2019-09-17 |
| 1023662590 | Shane Arthur Gulley | Counselor | 500 N. Morain St Suite 1250, Kennewick, WA 99336 | 2019-08-01 |
| 1063973873 | Farah Saleem | Student in an Organized Health Care Education/Training Program | 212 W. 10th Avenue,suite 202, Kennewick, WA 99336 | 2019-03-26 |
| 1255897690 | Thomas Stanley Mcgowan | Student in an Organized Health Care Education/Training Program | Tri-cities Cancer Center, 7350 W. Deschutes Ave, Building A, Kennewick, WA 99336 | 2019-02-11 |
| 1770068280 | Remedy Urgent Mobile Medicine Pllc | Nurse Practitioner | 3311 West Clearwater Avenue, Suite D210, Kennewick, WA 99336 | 2018-10-01 |
| 1740767011 | Zachary Wilber Fournier | Specialist/Technologist | Toyota Center - 7000 West Grandridge Blvd, Kennewick, WA 99336 | 2018-07-19 |
| 1649780693 | Alan Arnold Hanson | Chiropractor | 8350 W. Grandridge Blvd #100, Kennewick, WA 99336 | 2017-10-04 |
| 1922528827 | Sarah Nicole Childress | Counselor | 415 North Morain St, Kennewick, WA 99336 | 2017-06-21 |
| Find all providers in zip 99336 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225550734 | Chantelle Elizabeth Roberts | Physician Assistant | 2618 S Lyle St, Kennewick, WA 99337-7821 | 2017-07-17 |
| 1699103036 | Zachary Daniel Mcnair | Physician Assistant | 4008 W 27th Ave, Suite 103, Kennewick, WA 99337 | 2013-10-22 |
| 1457686826 | Larry W Nye | Physician Assistant | 4804 W Clearwater Avenue, Kadlec Clinic Urgent Care, Kennewick, WA 99336 | 2009-10-02 |
| 1356968390 | Kendra Mae Graham | Physician Assistant | 6802 W Rio Grande Ave Ste 1, Kennewick, WA 99336-7684 | 2020-06-25 |
| 1578101374 | Jessica Justo Alvarez | Physician Assistant | 6703 W Rio Grande Ave, Kennewick, WA 99336-2623 | 2019-12-12 |
| 1245740315 | Heather Boyle | Physician Assistant | 3730 Plaza Way Ste C6100, Kennewick, WA 99338-2718 | 2017-10-03 |
| 1851826408 | Jason E Higgs | Physician Assistant | 6703 W Rio Grande Ave, Kennewick, WA 99336-2623 | 2017-04-20 |
| 1427502467 | Jeffrey Allen Cummings | Physician Assistant | 7350 W Deschutes Ave, Kennewick, WA 99336-7802 | 2016-08-08 |
| 1962753830 | Jeannette Stuart Hart | Physician Assistant | 6710 W Okanogan Pl, Kennewick, WA 99336-8001 | 2012-10-01 |
| 1023378882 | Blake Bitton | Physician Assistant | 8508 W Gage Blvd Ste A101, Kennewick, WA 99336-8106 | 2012-05-25 |
| Find all providers in KENNEWICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.