Bolton, Mary Darlene

Bolton, Mary Darlene is an individual health care provider with primary practice located at 605 Stadium Dr , Hattiesburg MS 39401-4156. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bolton, Mary Darlene can be contacted via phone (601) 450-0310.

Contact Information

Primary practice address
605 Stadium Dr Hattiesburg MS 39401-4156
Phone: (601) 450-0310
Fax: (601) 450-0321
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R79429 Mississippi

Profile Details

NPI number 1346227741
LBN Legal business name Bolton, Mary Darlene
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
Last updated May 1st, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346227741 NPPES
Mississippi MEDICAID 00114669
Mississippi Other 3565141
Mississippi Other 4593131

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