MEDICARE: RICHARD E BOYER APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0200X	Critical Care Medicine Registered Nurse	62647	OK
2	363L00000X	Nurse Practitioner	212595	OK

General Provider Information

NPI Number	:	1093434847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD E BOYER APRN

Provider Business Mailing Address
First Line	:	18222 E 49TH PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74134-7316
Country	:	US
Telephone Number	:	918-261-8724
Fax Number	:

Provider Business Practice Location Address
First Line	:	7912 E 31ST CT STE 320
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74145-1305
Country	:	US
Telephone Number	:	918-496-8499
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2022
Last Update Date	:	07/30/2023

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Directions to “ RICHARD E BOYER APRN” Practice Location

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