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General NPI Number Information
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NPI Number | 1356265474
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Entity Type | Individual
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Provider Name | CASSANDRA BOLDEN RN
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Gender | Female
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Dates
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Enumeration Date | 08/10/2026
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Last Update Date | 08/10/2026
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Provider Practice Location Address
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Address Line | 6211 TAYLOR DR
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City | FLINT
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State | MI
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Zip | 48507-4665
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Country | US
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Telephone | 810-237-0799
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Fax |
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Provider Business Mailing Address
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Address Line | 525 OKEMOS ST
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City | MASON
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State | MI
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Zip | 48854-1224
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Country | US
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Telephone | 517-833-8100
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Fax | 517-676-5460
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704335498
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License Number State | MI
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