=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265011852
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY ELAINE BOYD FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/02/2021
-----------------------------------------------------
Last Update Date | 01/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 570 COLUMBIA AVE
-----------------------------------------------------
City | DEL NORTE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81132-2200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-849-0019
-----------------------------------------------------
Fax | 719-657-1313
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 575 8TH ST
-----------------------------------------------------
City | DEL NORTE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81132-2238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-849-0019
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APN.0996041
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------