Healthcare Provider Details

I. General information

NPI: 1023740883
Provider Name (Legal Business Name): KRISTINA COLLINS BOYD CNM, APRN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 YORKTOWN AVE STE 109
DURHAM NC
27713-1474
US

IV. Provider business mailing address

102 SPRINGLAND CT
CARY NC
27519-5225
US

V. Phone/Fax

Practice location:
  • Phone: 984-330-1694
  • Fax: 336-450-1770
Mailing address:
  • Phone: 205-393-3762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number299361
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-46913
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number838
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: