Healthcare Provider Details

I. General information

NPI: 1891129441
Provider Name (Legal Business Name): JAMIE JO BOYLE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2013
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MAIN ST
WELLSVILLE OH
43968-1662
US

IV. Provider business mailing address

PO BOX 645409
PITTSBURGH PA
15264-5252
US

V. Phone/Fax

Practice location:
  • Phone: 330-362-4799
  • Fax:
Mailing address:
  • Phone: 330-386-6442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.15124
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: