Healthcare Provider Details

I. General information

NPI: 1598301459
Provider Name (Legal Business Name): AMANDA LAUREN BOYLE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 KING AVE
DENNISON TX
75020
US

IV. Provider business mailing address

4511 HUMMINGBIRD DR
SHERMAN TX
75092-4299
US

V. Phone/Fax

Practice location:
  • Phone: 903-816-1728
  • Fax:
Mailing address:
  • Phone: 903-816-1728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP141625
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAP141625
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: