Doctor Name: | MRS. JESSICA LEA BOYD |
NPI Number: | 1396062162 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 4704214486 |
Business Practice Address: | 1280 Borg Ave Temperance, MI - 481822607 |
Business Phone Number: | 7343848711 |
Business Fax Number: | |
Mailing Address: | 1280 Borg Ave, TEMPERANCE |
State: | MI |
Postal Code: | 481822607 |
Phone Number: | 7343848711 |
Fax Number: | |
NPI Enumeration Date: | 05/03/2010 |
NPI Last Update Date: | 05/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 4704214486 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |