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Contact Information

SHANNON K BOLES, ACNP
4901 FOREST PARK AVE
DIV SURG ACCS, STE 340
SAINT LOUIS, MO63108-1495
 Phone: 314-362-5298
 Fax: 888-824-2176
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acute Care

363LA2100X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SHANNON K BOLES · (Female)

NPI Number 1760552665
Status Active
Credentials ACNP
Entity Individual
Enumeration date 11/08/2006
Last updated 04/15/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MO License # 2000165054
  • MO Medicaid 420007468
Hospital affiliation(s)
  • BARNES JEWISH HOSPITAL - (Acute Care)
    ONE BARNES-JEWISH HOSPITAL PLAZA
    SAINT LOUIS, MO 63110
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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