Individual
LAUREN ELIZABETH BOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
3217 MABEL ST, SHREVEPORT, LA 71103-4022
(318) 631-9121
(318) 631-9126
Mailing address
PO BOX 38150, SHREVEPORT, LA 71133-8150
(318) 631-9121
(318) 631-9126
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
302215
LA
Other
Enumeration date
09/16/2016
Last updated
05/01/2023
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