NPI | 1073196648 |
---|---|
Professional Name | STEPHANIE LASHAE BOLDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH F09220136) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 283570) |
Enumeration Date | 2021-05-03 |
Last Update Date | 2022-12-30 |