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NPI Code Detail

MEDICARE: ERSKALEAN KEWANA BOYD REGISTERED NURSE

MEDICARE:   ERSKALEAN KEWANA BOYD  REGISTERED NURSE
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
1163W00000XRegistered Nurse2013031996MO

General Provider Information

NPI Number : 1881466233
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERSKALEAN KEWANA BOYD REGISTERED NURSE
Provider Business Mailing Address
First Line : 3407 S JEFFERSON AVE STE 8
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63118-3119
Country : US
Telephone Number : 314-484-2273
Fax Number :
Provider Business Practice Location Address
First Line : 3407 S JEFFERSON AVE STE 8
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63118-3119
Country : US
Telephone Number : 314-484-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2023
Last Update Date : 10/27/2023

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Directions to “ ERSKALEAN KEWANA BOYD REGISTERED NURSE” Practice Location

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