Healthcare Provider Details

I. General information

NPI: 1780555086
Provider Name (Legal Business Name): KIRSTEN RACHEL BOYD BSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 ROGERS AVE
FORT SMITH AR
72903-4100
US

IV. Provider business mailing address

2513 KEVIN ST
VAN BUREN AR
72956-4123
US

V. Phone/Fax

Practice location:
  • Phone: 479-314-6055
  • Fax:
Mailing address:
  • Phone: 479-262-4707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number233985
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: