Healthcare Provider Details

I. General information

NPI: 1316590672
Provider Name (Legal Business Name): KATHERINE LYNANN BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 03/25/2020
Certification Date: 03/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 NW 13TH ST STE 3D
BOCA RATON FL
33486-2337
US

IV. Provider business mailing address

951 NW 13TH ST STE 3D
BOCA RATON FL
33486-2337
US

V. Phone/Fax

Practice location:
  • Phone: 561-818-8728
  • Fax:
Mailing address:
  • Phone: 561-392-0310
  • Fax: 561-368-0911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11003282
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: