MEDICARE: LAUREN BOYLES FNP-C

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	363LF0000X	Family Nurse Practitioner	1016099	TX

General Provider Information

NPI Number	:	1538766092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN BOYLES FNP-C

Provider Business Mailing Address
First Line	:	5705 WILMINGTON DR
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-7963
Country	:	US
Telephone Number	:	214-714-7983
Fax Number	:

Provider Business Practice Location Address
First Line	:	7777 FOREST LN STE C685
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-6885
Country	:	US
Telephone Number	:	972-566-7799
Fax Number	:

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

Provider Enumeration Date	:	10/07/2020
Last Update Date	:	10/07/2020

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