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NPI Code Detail

MEDICARE: PASCHA J BOYD APN

MEDICARE: PASCHA J BOYD APN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner143473MO

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 : 1639175912
Entity Type Code : Individual
Provider Name (Legal Business Name) : PASCHA J BOYD APN
Provider Business Mailing Address
First Line : 1805 E WALNUT ST
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-6425
Country : US
Telephone Number : 573-777-7500
Fax Number : 573-777-7505
Provider Business Practice Location Address
First Line : 1300 E BRADFORD PKWY
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-4264
Country : US
Telephone Number : 417-761-5000
Fax Number : 417-761-5011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 04/06/2014

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