Bolden, Willie Mary

Bolden, Willie Mary is an individual health care provider with primary practice located at 112 W Peeler Ave , Shaw MS 38773-8710. 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, Willie Mary can be contacted via phone (662) 745-6638.

Contact Information

Primary practice address
112 W Peeler Ave Shaw MS 38773-8710
Phone: (662) 745-6638
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 903205 Mississippi

Profile Details

NPI number 1518428283
LBN Legal business name Bolden, Willie Mary
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2019
Last updated Mar 26th, 2019 - about 5 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.

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