Provider Demographics
NPI:1891552725
Name:SHEILA BOLFA PMHNP BC LLC
Entity Type:Organization
Organization Name:SHEILA BOLFA PMHNP BC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLFA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:337-849-8282
Mailing Address - Street 1:128 ODESSA RD
Mailing Address - Street 2:
Mailing Address - City:DUSON
Mailing Address - State:LA
Mailing Address - Zip Code:70529-4437
Mailing Address - Country:US
Mailing Address - Phone:337-849-8282
Mailing Address - Fax:337-534-0220
Practice Address - Street 1:2520 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-5306
Practice Address - Country:US
Practice Address - Phone:337-234-5614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty