MARY DARLENE BOLTON FNP-BC NPI 1346227741

NPI Information

NPI: 1346227741
Provider Name: MARY DARLENE BOLTON, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
605 STADIUM DR
HATTIESBURG, MS
ZIP 39401
Phone: (601) 450-0310
Get Directions

Mary Darlene Bolton, FNP-BC is a family nurse practitioner in Hattiesburg, MS. Mary Darlene Bolton, FNP-BC NPI is 1346227741. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

605 STADIUM DR
HATTIESBURG, MS
ZIP 39401-156
Phone: (601) 450-0310
Fax: (601) 450-0321

The enumeration date for this NPI number is 12/27/2005 and was last updated on 5/1/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	R79429	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500001256	MEDICARE ID-TYPE UNSPECIFIED	MISSISSIPPI	MS MEDICARE NUMBER
2	00114669	MEDICAID	MISSISSIPPI
3	3565141	OTHER	MISSISSIPPI	CIGNA
4	4593131	OTHER	MISSISSIPPI	AETNA
5	R34683	MEDICARE UPIN	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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