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Mrs. Willie Mary Bolden
Family Nurse Practitioner in Shaw, Mississippi
NPI 1518428283

Willie Mary Bolden is a Family Nurse Practitioner based in Shaw, MS and is specialized in Family. Willie Mary Bolden practices in Shaw, MS. The NPI Number for Willie Mary Bolden is 1518428283 and holds a License No. 903205 (Mississippi).

The current practice location address for Willie Mary Bolden is 112 W Peeler Ave, Shaw, MS and can be reached out via phone at 662-745-6638.

Location: 112 W Peeler Ave, Shaw, MS, 38773-8710
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518428283
Provider Name
Willie Mary Bolden
Credential
Provider Entity Type
Individual
Gender
Female
Address
112 W Peeler Ave, Shaw, MS, 38773-8710
Phone Number
662-745-6638
Fax Number
Provider Enumeration Date
03/26/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
112 W Peeler Ave
City
Shaw
State
Mississippi
Zip
38773-8710
Phone Number
662-745-6638
Fax Number
person
Provider Business Mailing Address Details
Address
112 W Peeler Ave
City
Shaw
State
Mississippi
Zip
38773-8710
Phone Number
662-745-6638
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
903205 (Mississippi)
Definition
Definition to come...
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