Healthcare Provider Details

I. General information

NPI: 1093513665
Provider Name (Legal Business Name): CHERLIESA C BOYD APRN, CNP, PMNHP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 07/01/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577 NEIL AVE
COLUMBUS OH
43201-2320
US

IV. Provider business mailing address

1577 NEIL AVE
COLUMBUS OH
43201-2320
US

V. Phone/Fax

Practice location:
  • Phone: 614-292-8900
  • Fax:
Mailing address:
  • Phone: 614-292-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number530741
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0039673
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: