Healthcare Provider Details

I. General information

NPI: 1043129547
Provider Name (Legal Business Name): JULIE MAXINE BOYLE STUDENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 SOUTH NEW STREET
WEST CHESTER PA
19383-0001
US

IV. Provider business mailing address

1025 PALM HILL RD
PALM PA
18070-1106
US

V. Phone/Fax

Practice location:
  • Phone: 610-436-1000
  • Fax:
Mailing address:
  • Phone: 267-746-0865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: