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1578547980

NPI Code Detail

MEDICARE: KAREN LEA BYRD NP

MEDICARE: KAREN LEA BYRD 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
1	363L00000X	Nurse Practitioner	600047	NC
2	363LG0600X	Gerontology Nurse Practitioner	196457	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7770615	OTHER		AETNA
3	B4293	OTHER		MEDCOST

General Provider Information

NPI Number	:	1578547980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN LEA BYRD NP

Provider Business Mailing Address
First Line	:	1 BOSTON MEDICAL CTR PL
Second Line	:	DOWLING NORTH, SUITE 5108
City	:	BOSTON
State	:	MA
Zip	:	02118-2908
Country	:	US
Telephone Number	:	617-894-6795
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BOSTON MEDICAL CTR PL
Second Line	:	DOWLING NORTH, SUITE 5108
City	:	BOSTON
State	:	MA
Zip	:	02118-2908
Country	:	US
Telephone Number	:	617-894-6795
Fax Number	:

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	10/27/2020

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Directions to “ KAREN LEA BYRD NP” Practice Location

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