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NPI Code Detail

MEDICARE: PAMELA ELIZABETH BOYLESTON CRNA

MEDICARE: PAMELA ELIZABETH BOYLESTON CRNA
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
1367500000XCertified Registered Nurse Anesthetist364AK
2367500000XCertified Registered Nurse Anesthetist7271484ID

General Provider Information

NPI Number : 1659696227
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA ELIZABETH BOYLESTON CRNA
Provider Business Mailing Address
First Line : PO BOX 542
Second Line :
City : GIRDWOOD
State : AK
Zip : 99587-0542
Country : US
Telephone Number : 907-602-0285
Fax Number :
Provider Business Practice Location Address
First Line : 1397 WEIMER RD
Second Line :
City : TAOS
State : NM
Zip : 87571-6253
Country : US
Telephone Number : 907-602-0285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2010
Last Update Date : 04/06/2026

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Directions to “ PAMELA ELIZABETH BOYLESTON CRNA” Practice Location

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