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General NPI Number Information
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NPI Number | 1225851793
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Entity Type | Individual
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Provider Name | MICHELLE ALEXANDRIA BOYER
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 701 N 1ST ST
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City | SPRINGFIELD
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State | IL
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Zip | 62781-0001
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Country | US
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Telephone | 217-788-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 813 PULASKI ST
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City | LINCOLN
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State | IL
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Zip | 62656-2901
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Country | US
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Telephone | 217-737-2470
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209027477
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License Number State | IL
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