Individual provider · NPI-1

Heather Nicole Bolden, NP-C

Nurse Practitioner, Family · Fort Benning, GA

NPI number1659655629

StatusActive

Last updated in NPPESOct 24, 2025

Details

NPI: 1659655629
Entity type: Individual (NPI-1)
Name: Ms. Heather Nicole Bolden
Credential: NP-C
Sex: Female
Sole proprietor: Yes
Enumeration date: Oct 7, 2011
Certification date: Oct 24, 2025
Last updated: Oct 24, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	RN175548	GA	Yes
363LX0106X	Nurse Practitioner, Occupational Health	RN175548	GA

Practice location

6600 Van Aalst Blvd
Martin Army Community Hospital-Dph
Fort Benning, GA 31905

Phone 762-408-1418 · Fax 762-408-8156

Mailing address

6600 Van Aalst Blvd
Fort Benning, GA 31905-2102

Phone 762-408-1418 · Fax 762-408-8156

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