Kimiko Bolden

NPI 1114837580 · on the registry since 2026

Practice

Address: 508 S Rogers St
Pooler, GA 31322
Phone: (912) 748-6840
Organisation at this address: Resorts At Pooler Inc
The Place At Pooler Llc
The Place At Pooler, Llc
Eagles Nest Truck Station Inc
Eagle'S Nest Truck Station, Inc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 163WC0400X
163WC0400X
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2026-09-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia