Healthcare Provider Details

I. General information

NPI: 1710548706
Provider Name (Legal Business Name): MONICA ALMY-BOYLAN MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W KIEFFER RD
MICHIGAN CITY IN
46360-9599
US

IV. Provider business mailing address

2022 KELLE DR
CHESTERTON IN
46304-8708
US

V. Phone/Fax

Practice location:
  • Phone: 219-878-3217
  • Fax: 219-814-4788
Mailing address:
  • Phone: 219-364-4004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number041.403144
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71009799A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: