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MRS. CRYSTAL ANNE BOLOS FNP-BC
NPI 1891447298
Nurse Practitioner - Family in Shelby Township, MI

Active since January 26, 2022
6300 22 MILE RD STE 2, SHELBY TOWNSHIP, MI 48317(586) 726-9860 Get Directions Write a Review

NPPES record last updated: January 26, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mrs. Crystal Anne Bolos Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. CRYSTAL ANNE BOLOS FNP-BC (NPI 1891447298) is an individual family provider in Shelby Township, Michigan, licensed in Michigan (2021100905) and active in the NPI registry since January 2022. She maintains a secondary practice location in Warren.

NPPES Registry Identity

NPI1891447298
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. CRYSTAL ANNE BOLOSCredential: FNP-BC
Location Address6300 22 MILE RD STE 2Shelby Township, MI 48317-2106
Mailing Address11800 E 12 Mile RdWarren, MI 48093-3472 · (586) 573-5111
Phone(586) 726-9860
Sole ProprietorNo
Enumeration DateJanuary 26, 2022
NPPES CertifiedJanuary 25, 2022
✔ NPI 1891447298 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MI · 2021100905
6300 22 MILE RD STE 2, Shelby Township, MI 48317
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Secondary Practice Location 1

Location 111800 E 12 Mile RdWarren, MI 48093-3472 · Phone (586) 573-5111

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ROBERT ALLEN PARKS PA
Physician Assistant
6300 22 MILE RD STE 2
SHELBY TWP, MI 48317
Macomb County (586) 726-9860

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Bolos's NPI number?

The NPI number for Crystal Bolos is 1891447298. It was assigned to this individual provider in the NPPES registry on January 26, 2022.

Where is Crystal Bolos located?

Crystal Bolos practices at 6300 22 Mile Rd Ste 2, Shelby Township, MI 48317. The listed phone number is (586) 726-9860.

What is Crystal Bolos's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Crystal Bolos was last updated on January 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.