Healthcare Provider Details

I. General information

NPI: 1528168630
Provider Name (Legal Business Name): MICHELE BOYD CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 KINSLEY ST SUITE 4
NASHUA NH
03060-3634
US

IV. Provider business mailing address

139 JOPPA RD
MERRIMACK NH
03054-3109
US

V. Phone/Fax

Practice location:
  • Phone: 603-882-1501
  • Fax: 603-882-9747
Mailing address:
  • Phone: 603-589-1885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number04200154
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number043721-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: