Healthcare Provider Details

I. General information

NPI: 1609046135
Provider Name (Legal Business Name): DEBORAH D BOYCE RNC, MSN, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 KENNERLY RD
SAINT LOUIS MO
63128-2106
US

IV. Provider business mailing address

806 WILD HICKORY LN
BALLWIN MO
63021-6624
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-4859
  • Fax: 314-525-4832
Mailing address:
  • Phone: 636-391-1656
  • Fax: 636-394-5807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number150546
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: