Provider Demographics
NPI:1679374664
Name:BOLL, KAYLEIGH
Entity type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:
Last Name:BOLL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 EILEEN DONDERO FOLEY AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4596
Mailing Address - Country:US
Mailing Address - Phone:603-570-3119
Mailing Address - Fax:
Practice Address - Street 1:100 EILEEN DONDERO FOLEY AVE STE 110
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4596
Practice Address - Country:US
Practice Address - Phone:603-570-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program