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General NPI Number Information
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NPI Number | 1851953574
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Entity Type | Individual
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Provider Name | YOLANDA FELITA BOYD-GANTT NP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 1911 HAMPTON ST
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City | COLUMBIA
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State | SC
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Zip | 29201-3535
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Country | US
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Telephone | 803-849-8430
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Fax | 803-445-1138
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Provider Business Mailing Address
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Address Line | PO BOX 100 DEPT#394
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City | MEMPHIS
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State | TN
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Zip | 38148-0001
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Country | US
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Telephone | 941-300-4440
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Fax | 941-404-1760
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN11016703
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 22993
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License Number State | SC
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