Provider Demographics
NPI:1770114118
Name:BOLDEN, ABBEY (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ABBEY
Middle Name:
Last Name:BOLDEN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 MILLER CT
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-7267
Mailing Address - Country:US
Mailing Address - Phone:317-847-1957
Mailing Address - Fax:
Practice Address - Street 1:929 MILLER CT
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-7267
Practice Address - Country:US
Practice Address - Phone:317-642-0221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71009766A363LP0808X
IN28221810A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health