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General NPI Number Information
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NPI Number | 1508738279
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Entity Type | Individual
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Provider Name | BURTIE DALE BOYCE NP
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Gender | Male
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 930 PROFESSIONAL PARK DR
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City | CLARKSVILLE
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State | TN
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Zip | 37040-5136
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Country | US
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Telephone | 931-536-6420
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Fax |
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Provider Business Mailing Address
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Address Line | 253 DENNY RD
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City | CLARKSVILLE
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State | TN
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Zip | 37043-3907
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Country | US
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Telephone | 931-802-3090
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 40050
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License Number State | TN
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