MEDICARE: MRS. COLLEEN HOROHOE BOYD 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	363LF0000X	Family Nurse Practitioner	337663	NY
2	363LF0000X	Family Nurse Practitioner	18258	SC
3	363L00000X	Nurse Practitioner	18258	SC

General Provider Information

NPI Number	:	1740524768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COLLEEN HOROHOE BOYD NP

Provider Business Mailing Address
First Line	:	PO BOX 530062
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30353-0062
Country	:	US
Telephone Number	:	843-572-7727
Fax Number	:

Provider Business Practice Location Address
First Line	:	5500 FRONT ST STE 230
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29486-8140
Country	:	US
Telephone Number	:	843-569-1856
Fax Number	:	843-569-1879

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

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	05/31/2024

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