Individual
CARISSA MARTINE BOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
249 BEAUVOIR RD STE B2, BILOXI, MS 39531-4008
(601) 283-8999
Mailing address
109 SELLERS ST, WIGGINS, MS 39577-8743
(601) 528-0203
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902960
MS
Other
Enumeration date
11/30/2018
Last updated
01/08/2023
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