Provider Demographics
NPI:1881227700
Name:BOLDEA, EVA (MSN-ACNS)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:BOLDEA
Suffix:
Gender:F
Credentials:MSN-ACNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 E ROSS AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-4146
Mailing Address - Country:US
Mailing Address - Phone:480-415-1088
Mailing Address - Fax:
Practice Address - Street 1:810 E ROSS AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-4146
Practice Address - Country:US
Practice Address - Phone:480-415-1088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4650364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health