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General NPI Number Information
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NPI Number | 1457759185
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Entity Type | Individual
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Provider Name | DARLENE BOLDON CNA
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Gender | Female
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Dates
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Enumeration Date | 12/11/2014
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Last Update Date | 12/12/2014
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Provider Practice Location Address
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Address Line | 12435 DESSAU RD APT 1121
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City | AUSTIN
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State | TX
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Zip | 78754-1980
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Country | US
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Telephone | 512-905-6083
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Fax |
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Provider Business Mailing Address
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Address Line | 12435 DESSAU RD APT 1121
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City | AUSTIN
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State | TX
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Zip | 78754-1980
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Country | US
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Telephone | 512-905-6083
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 37814
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | NA10082522
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 355674014
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | 35453989
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License Number State | TX
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