Healthcare Provider Details

I. General information

NPI: 1306195961
Provider Name (Legal Business Name): DARLEEN M BOYD R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6218 S 7TH ST
PHOENIX AZ
85042-4211
US

IV. Provider business mailing address

909 W VINEYARD RD
PHOENIX AZ
85041-5904
US

V. Phone/Fax

Practice location:
  • Phone: 602-304-3117
  • Fax:
Mailing address:
  • Phone: 602-232-4210
  • Fax: 602-232-4291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN086890
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: