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)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