Provider Demographics
NPI:1487416806
Name:BOLFA, SHEILA MARIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARIE
Last Name:BOLFA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 ODESSA RD
Mailing Address - Street 2:
Mailing Address - City:DUSON
Mailing Address - State:LA
Mailing Address - Zip Code:70529-4437
Mailing Address - Country:US
Mailing Address - Phone:337-849-8282
Mailing Address - Fax:
Practice Address - Street 1:128 ODESSA RD
Practice Address - Street 2:
Practice Address - City:DUSON
Practice Address - State:LA
Practice Address - Zip Code:70529-4437
Practice Address - Country:US
Practice Address - Phone:337-849-8282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA234341363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health