Male or Other

Stephen Bolivar NP

Family Nurse Practitioner in Laurel, MS(View on Map)

Full Name

Stephen Bolivar NP

NPI Number

1598199291

NPI Type

Individual Provider

Gender

Male

Enumeration Date

08/29/2013

Specialties

(Taxonomies)

Code

363LF0000X

Primary Taxonomy

Yes

Licenses

State

Mississippi

License Number

R888641

Contact
Information

Purpose

Mailing
Location

Address

235 S 14TH AVE
235 S 14TH AVE

City

Laurel
Laurel

State

MS
MS

Postal Code

39440-4227
39440-4227

Country

US
US

Telephone Number

(601) 651-2832
(601) 651-2832

Identifiers

Identifier

07029064

Identifier State

MS

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/28/2015

Provider Address

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