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Contact Information

LANDIN BOLER
9600 BROADWAY EXT STE B103
OKLAHOMA CITY, OK73114-7408
 Phone: 405-715-3610
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

NPI Profile & details for LANDIN BOLER · (Male)

NPI # 1265046403
Status Active
Credentials
Entity Individual
Enumeration date 09/04/2020
Last updated 09/04/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 108944
Hospital affiliation(s)
  • INTEGRIS CANADIAN VALLEY HOSPITAL - (Acute Care)
    1201 HEALTH CENTER PARKWAY
    YUKON, OK 73099
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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