Stephanie Bolster

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

126128 Issued in AR

Practice address

2911 Linwood Dr
Paragould, AR 72450-7384

Phone

(870) 450-0585

NPI assigned

Mar 11, 2025

Last updated

Mar 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kidspot Paragould Inc

  • Multi-Specialty Clinic/Center
  • Paragould, AR
  • NPI 1649014044
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1104625268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 LINWOOD DR",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724507384",
            "telephone_number": "870-450-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 LINWOOD DR",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724507384",
            "telephone_number": "870-450-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLSTER",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "126128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bret Tyler Bloodworth, OTD R/L
• Amanda Blue, MHPP
• Whitley Nicole Blue, RN
• Marshia Jean Bobo, AA CDA MHPP
• Susan Leigh Boling, BCBA
• Karen Bolt, RN
• Kathryn Boone
• Lucretia Leann Bostic, MHPP
• Dylan Bosze, DPT
• Katelin Bowden

• Registered Nurse in Paragould, AR
• Providers in Paragould, AR by specialty
• Registered Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.