Individual
MRS. TANIKA R BOLAR-BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
9802 PENN STATION ST, CORNELIUS, NC 28031-8181
(704) 896-3592
Mailing address
PO BOX 1110, ALBANY, NY 12201-1110
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
164W00000X
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060162
LICENSED PRACTICAL NURSE
NC
01
—
231137
LICENSED PRACTICAL NURSE
NY
Enumeration date
06/16/2006
Last updated
11/29/2017
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