MEDICARE: FLORENCE BOAKAI-PAYNE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	2469160	MN

General Provider Information

NPI Number	:	1245887637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLORENCE BOAKAI-PAYNE

Provider Business Mailing Address
First Line	:	19195 ZANE ST NW
Second Line	:
City	:	ELK RIVER
State	:	MN
Zip	:	55330-2829
Country	:	US
Telephone Number	:	763-412-0078
Fax Number	:

Provider Business Practice Location Address
First Line	:	19195 ZANE ST NW
Second Line	:
City	:	ELK RIVER
State	:	MN
Zip	:	55330-2829
Country	:	US
Telephone Number	:	763-412-0078
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2019
Last Update Date	:	08/21/2019

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Directions to “ FLORENCE BOAKAI-PAYNE ” Practice Location

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