MEDICARE: MS. LORIE LYNETTE BOYD FNP

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	363LF0000X	Family Nurse Practitioner	690509	TX

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

General Provider Information

NPI Number	:	1679667471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORIE LYNETTE BOYD FNP

Provider Business Mailing Address
First Line	:	2525 HOLLY HALL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-4124
Country	:	US
Telephone Number	:	713-566-6412
Fax Number	:	713-566-6519

Provider Business Practice Location Address
First Line	:	602 GIRARD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-6218
Country	:	US
Telephone Number	:	832-615-1219
Fax Number	:	713-237-1715

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/28/2012

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