MEDICARE: ROSEMARY ELLEN BOYD RN IBCLC

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	163W00000X	Registered Nurse	95062701	CA
2	163WH0200X	Home Health Registered Nurse	95062701	CA
3	163WI0500X	Infusion Therapy Registered Nurse	95062701	CA
4	163WM0102X	Maternal Newborn Registered Nurse	95062701	CA
5	163WN0002X	Neonatal Intensive Care Registered Nurse	95062701	CA
6	163WN0003X	Low-Risk Neonatal Registered Nurse	95062701	CA
7	163WP0200X	Pediatric Registered Nurse	95062701	CA
8	163WP1700X	Perinatal Registered Nurse	95062701	CA
9	163WS0121X	Plastic Surgery Registered Nurse	95062701	CA
10	163WW0101X	Ambulatory Women's Health Care Registered Nurse	95062701	CA
11	163WX0002X	High-Risk Obstetric Registered Nurse	95062701	CA
12	163WL0100X	Lactation Consultant (Registered Nurse)	95062701	CA

General Provider Information

NPI Number	:	1659913689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY ELLEN BOYD RN IBCLC

Provider Business Mailing Address
First Line	:	9012 HASKELL AVE
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-3112
Country	:	US
Telephone Number	:	971-282-3746
Fax Number	:

Provider Business Practice Location Address
First Line	:	9012 HASKELL AVE
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-3112
Country	:	US
Telephone Number	:	971-282-3746
Fax Number	:

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

Provider Enumeration Date	:	10/10/2019
Last Update Date	:	10/10/2019

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