Provider Demographics
NPI:1497818801
Name:BOLDEN, YVONNE THERSA (RN CPNP)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:THERSA
Last Name:BOLDEN
Suffix:
Gender:F
Credentials:RN CPNP
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Other - First Name:
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Mailing Address - Street 1:1 PERKINS SQ
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1063
Mailing Address - Country:US
Mailing Address - Phone:330-543-8050
Mailing Address - Fax:330-543-3935
Practice Address - Street 1:1 PERKINS SQ
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1063
Practice Address - Country:US
Practice Address - Phone:330-543-8050
Practice Address - Fax:330-543-3935
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHCOA.02770-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner