Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP127549 | TX |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP127549 | TX |
NPI | 1013397793 |
---|---|
Provider Name | Olha Bovda |
First Address | Richardson, TX 75082-4278 |
Second Address | Richardson, TX 75082-4278 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2015 |
Last Update Date | 14/04/2020 |