Healthcare Provider Details

I. General information

NPI: 1407831282
Provider Name (Legal Business Name): NANCY A BOYD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 WHITEHALL DR SUITE 109-114
ST AUGUSTINE FL
32086-5269
US

IV. Provider business mailing address

1302 RIVER ST
PALATKA FL
32177-5042
US

V. Phone/Fax

Practice location:
  • Phone: 904-829-2782
  • Fax: 904-829-2494
Mailing address:
  • Phone: 386-328-8371
  • Fax: 385-328-1519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberARNP1098192
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1098192
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP1098192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: