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General NPI Number Information
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NPI Number | 1316214414
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Entity Type | Individual
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Provider Name | DESTINY BOLDEN ND, RN
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Gender | Female
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Dates
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Enumeration Date | 11/18/2011
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 964 HIGH HOUSE RD # 2017
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City | CARY
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State | NC
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Zip | 27513-3574
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Country | US
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Telephone | 504-345-8657
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Fax |
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Provider Business Mailing Address
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Address Line | 964 HIGH HOUSE RD # 2017
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City | CARY
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State | NC
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Zip | 27513-3574
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 73285
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License Number State | NE
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Taxonomy #5
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 263319
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 263319
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License Number State | NC
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Taxonomy #7
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 263319
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License Number State | NC
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Taxonomy #8
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Taxonomy Code | 163WN1003X
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Taxonomy Name | Nutrition Support Registered Nurse
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License Number | 263319
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License Number State | NC
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Taxonomy #9
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | NAT1000727
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License Number State | DC
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Taxonomy #12
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 263319
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License Number State | NC
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Taxonomy #13
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 263319
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License Number State | NC
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