Bolden, Phalan Larese
Bolden, Phalan Larese is an individual health care provider with primary practice located at 507 N Lindsay St , High Point NC 27262-4303. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bolden, Phalan Larese can be contacted via phone (336) 883-0029.Contact Information
Primary practice address
507 N Lindsay St
High Point NC 27262-4303
Phone: (336) 883-0029
Fax: (336) 883-0867
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 255762 | North Carolina |
Profile Details
| NPI number | 1184952277 |
|---|---|
| LBN Legal business name | Bolden, Phalan Larese |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 1st, 2009 |
| Last updated | May 9th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184952277 | NPPES |
| North Carolina | MEDICAID | 7006359 | |
| North Carolina | MEDICAID | NP2129 | |
| North Carolina | MEDICAID | 1184952277 |
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