MEDICARE: HANNAH BOYL RDN

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	133VN1501X	Sports Dietetics Nutrition Registered Dietitian
2	133V00000X	Registered Dietitian		MI

General Provider Information

NPI Number	:	1356983381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH BOYL RDN

Provider Business Mailing Address
First Line	:	5350 N SUMMIT ST UNIT 3100
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4176
Country	:	US
Telephone Number	:	989-798-1920
Fax Number	:

Provider Business Practice Location Address
First Line	:	5350 N SUMMIT ST UNIT 3100
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4176
Country	:	US
Telephone Number	:	989-798-1920
Fax Number	:

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

Provider Enumeration Date	:	10/10/2019
Last Update Date	:	06/01/2026

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