Healthcare Provider Details

I. General information

NPI: 1417294547
Provider Name (Legal Business Name): JESSICA MAY BOYCE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2013
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2438 GRATIOT RD SE
NEWARK OH
43056-9425
US

IV. Provider business mailing address

2438 GRATIOT RD SE
NEWARK OH
43056-9425
US

V. Phone/Fax

Practice location:
  • Phone: 740-404-1567
  • Fax:
Mailing address:
  • Phone: 740-404-1567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.437228
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: