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NPI Code Detail

MEDICARE: VICTORIA BOLDEN

MEDICARE: VICTORIA BOLDEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WE0003XEmergency Registered Nurse28251178CIN
2363L00000XNurse PractitionerF06260403IN

General Provider Information

NPI Number : 1871443036
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA BOLDEN
Provider Business Mailing Address
First Line : 5913 BELLINGHAM LN
Second Line :
City : FORT WAYNE
State : IN
Zip : 46835-1254
Country : US
Telephone Number : 260-415-1411
Fax Number :
Provider Business Practice Location Address
First Line : 11109 PARKVIEW PLAZA DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number : 260-266-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2026
Last Update Date : 06/16/2026

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Directions to “ VICTORIA BOLDEN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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