Healthcare Provider Details

I. General information

NPI: 1689509457
Provider Name (Legal Business Name): NAKAELAH BOYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5813 MAYFIELD RD
MAYFIELD HEIGHTS OH
44124-2932
US

IV. Provider business mailing address

2063 E 4TH ST APT 306
CLEVELAND OH
44115-1071
US

V. Phone/Fax

Practice location:
  • Phone: 440-753-1232
  • Fax:
Mailing address:
  • Phone: 228-382-7620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: