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General NPI Number Information
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NPI Number | 1386283000
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Entity Type | Individual
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Provider Name | ANNA BOYD PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/27/2019
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 11855 ULYSSES ST NE
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City | BLAINE
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State | MN
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Zip | 55434-3947
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Country | US
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Telephone | 763-581-0555
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Fax | 763-581-0510
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Provider Business Mailing Address
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Address Line | 1368 MICHELLE DR
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City | EAGAN
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State | MN
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Zip | 55123-1459
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Country | US
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Telephone | 651-343-2236
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 13735
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License Number State | MN
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