Provider Demographics
NPI:1275358020
Name:BOULWARE, ROBBIN ARTAVIA
Entity type:Individual
Prefix:
First Name:ROBBIN
Middle Name:ARTAVIA
Last Name:BOULWARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 COTTAGE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-9467
Mailing Address - Country:US
Mailing Address - Phone:704-222-1387
Mailing Address - Fax:
Practice Address - Street 1:1702 COTTAGE CREEK RD
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-9467
Practice Address - Country:US
Practice Address - Phone:704-222-1387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula