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NPI Code Detail

MEDICARE: JASON LEHAN BOYLAN NP

MEDICARE:   JASON LEHAN BOYLAN  NP
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
1363L00000XNurse Practitioner8392TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538116561
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON LEHAN BOYLAN NP
Provider Business Mailing Address
First Line : 24 FRANK LLOYD WRIGHT DR # J2000
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-9484
Country : US
Telephone Number : 734-747-6766
Fax Number : 734-222-3100
Provider Business Practice Location Address
First Line : 14288 E OLD US HIGHWAY 12
Second Line :
City : CHELSEA
State : MI
Zip : 48118-2700
Country : US
Telephone Number : 734-327-6115
Fax Number : 734-327-1164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 08/22/2024

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