Provider Demographics
NPI:1235644451
Name:BOLDEN, CHRISTA A (NP)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:A
Last Name:BOLDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:306 E RANDOL MILL RD STE 700
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-1410
Mailing Address - Country:US
Mailing Address - Phone:469-252-7088
Mailing Address - Fax:469-320-1947
Practice Address - Street 1:306 E RANDOL MILL RD STE 700
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-1410
Practice Address - Country:US
Practice Address - Phone:469-252-7088
Practice Address - Fax:469-320-1947
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP135795363L00000X, 363LF0000X
TX343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No343800000XTransportation ServicesSecured Medical Transport (VAN)