STEPHEN BOLIVAR

SOUTHAVEN, MS
NPI1598199291
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  888641)
Enumeration Date2013-08-29
Last Update Date2025-08-19
Business Address
STEPHEN BOLIVAR NP
401 SOUTHCREST CIR STE 202
SOUTHAVEN, MS 38671-6719
Phone number: 662-536-2281
Mailing Address
STEPHEN BOLIVAR NP
235 S 14TH AVE
LAUREL, MS 39440-4227
Phone number: 601-651-2832
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