Stacy Bolden
Individual provider Active NPI Home Health Aide · Logansport, LA
NPI 1134844814 · NPPES record last updated Oct 5, 2022
Key facts
- NPI
- 1134844814
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- Practice address
- 1204 Williams St
Logansport, LA 71049-3196 - Phone
- (318) 840-6173
- NPI assigned
- Oct 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Yes |
Addresses
Primary practice location
1204 Williams St
Logansport, LA 71049-3196
Mailing address
1204 Williams St
Logansport, LA 71049-3196
Other providers in Logansport, LA
- 3Grands Enterprises LLC
- Kenneth Barnes
- Bennie G. Owens
- Katelyn Bolden
- Katherine Latreas Brame
- SH;Ronda Carter
- David Dixon Golden, OD, PA
- Amanda Denmon
- Dennis D Golden OD
All providers in Logansport, LA · Home Health Aide in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.