Provider Demographics
NPI:1760639926
Name:BOLTON, DAWDA KINSHASA (NP)
Entity Type:Individual
Prefix:MRS
First Name:DAWDA
Middle Name:KINSHASA
Last Name:BOLTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8751 COLLIN MCKINNEY PKWY STE 1102
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1872
Mailing Address - Country:US
Mailing Address - Phone:972-668-7500
Mailing Address - Fax:
Practice Address - Street 1:8751 COLLIN MCKINNEY PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-1656
Practice Address - Country:US
Practice Address - Phone:972-668-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117100363LF0000X
TXF0708468363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily