Healthcare Provider Details

I. General information

NPI: 1902428444
Provider Name (Legal Business Name): TAMARA MORGAN-BOYD BCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 W MAIN ST
BELLEVILLE IL
62223-4402
US

IV. Provider business mailing address

19 WINDSOR DR
BELLEVILLE IL
62223-2127
US

V. Phone/Fax

Practice location:
  • Phone: 618-641-8973
  • Fax:
Mailing address:
  • Phone: 314-562-6442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: