Physician Compare National (NPI:1669885182)

HEALTHCARE PROVIDER: KATIE BOYLAN FNP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1669885182
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7214250786
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150108001902
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BOYLAN
	Individual professional last name
Provider First Name	KATIE
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	10131 COORS BLVD NW
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE H8
	Group Practice or individual's line 2 address
City	ALBUQUERQUE
	Group Practice or individual's city
State	NM
	Group Practice or individual's state
Zip Code	871144048
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y