Healthcare Provider Details

I. General information

NPI: 1538077235
Provider Name (Legal Business Name): KATRINA MARIE BOYD ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 E MAYO BLVD
PHOENIX AZ
85050-4880
US

IV. Provider business mailing address

33833 N 67TH ST
SCOTTSDALE AZ
85266-7245
US

V. Phone/Fax

Practice location:
  • Phone: 602-449-4000
  • Fax:
Mailing address:
  • Phone: 408-859-7257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number100107
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: