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General NPI Number Information
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NPI Number | 1366125288
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Entity Type | Individual
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Provider Name | CORBIN BOYD PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 6025 SHENANDOAH LN N
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City | PLYMOUTH
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State | MN
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Zip | 55446-4557
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Country | US
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Telephone | 763-252-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 12818 APRIL LN
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City | MINNETONKA
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State | MN
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Zip | 55305-2729
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Country | US
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Telephone | 952-237-4681
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 126122
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License Number State | MN
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